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1972604908

NPI Code Detail

MEDICARE: SCOTT DAVID KIRKLEY MD

MEDICARE: SCOTT DAVID KIRKLEY 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	208M00000X	Hospitalist Physician	2007007776	MO
2	207R00000X	Internal Medicine Physician	2007007776	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972604908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT DAVID KIRKLEY MD

Provider Business Mailing Address
First Line	:	PO BOX 957683
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63195-1921
Country	:	US
Telephone Number	:	573-756-6751
Fax Number	:	573-760-8044

Provider Business Practice Location Address
First Line	:	1106 HAZEL LN
Second Line	:
City	:	FARMINGTON
State	:	MO
Zip	:	63640-1999
Country	:	US
Telephone Number	:	573-756-6751
Fax Number	:	573-760-8044

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	09/26/2025

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Directions to “ SCOTT DAVID KIRKLEY MD” Practice Location

Language	Start Address	Practice Location

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