Brockman, Kirk Edward

Brockman, Kirk Edward is an individual health care provider with primary practice located at 1001 Cardwell St , St. Clair MO 63077. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Brockman, Kirk Edward can be contacted via phone (636) 629-3300.

Contact Information

Primary practice address
1001 Cardwell St St. Clair MO 63077
Phone: (636) 629-3300
Fax: (636) 629-7377
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X R2F53 Missouri

Profile Details

NPI number 1235139221
LBN Legal business name Brockman, Kirk Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2005
Last updated Mar 11th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235139221 NPPES
Missouri Other P01134547 RAILROAD MEDICARE
Missouri MEDICAID 202458204 RAILROAD MEDICARE

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