MEDICARE: DR. KIRK E FLURY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	R2C57	MO
2	207R00000X	Internal Medicine Physician	R2C57	MO

General Provider Information

NPI Number	:	1467450577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIRK E FLURY M.D.

Provider Business Mailing Address
First Line	:	2315 DOUGHERTY FERRY RD
Second Line	:	SUITE 205
City	:	SAINT LOUIS
State	:	MO
Zip	:	63122-3383
Country	:	US
Telephone Number	:	314-977-4701
Fax Number	:	314-977-9637

Provider Business Practice Location Address
First Line	:	2315 DOUGHERTY FERRY RD
Second Line	:	SUITE 205
City	:	SAINT LOUIS
State	:	MO
Zip	:	63122-3383
Country	:	US
Telephone Number	:	314-977-4701
Fax Number	:	314-977-9637

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	08/07/2013

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