MEDICARE: MATTHEW JAMES KIBLINGER MD

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	207P00000X	Emergency Medicine Physician	2020016494	MO

General Provider Information

NPI Number	:	1508386558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW JAMES KIBLINGER MD

Provider Business Mailing Address
First Line	:	6420 CLAYTON RD
Second Line	:
City	:	RICHMOND HEIGHTS
State	:	MO
Zip	:	63117-1811
Country	:	US
Telephone Number	:	314-768-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	232 S WOODS MILL RD
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63017-3485
Country	:	US
Telephone Number	:	314-205-6990
Fax Number	:

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

Provider Enumeration Date	:	06/21/2017
Last Update Date	:	09/16/2025

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