Creach, Kimberly M
Creach, Kimberly M is an individual health care provider with primary practice located at 2055 S Fremont Ave , Springfield MO 65804-2206. She recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as her primary health care specialty. Creach, Kimberly M can be contacted via phone (417) 820-2468.Contact Information
Primary practice address
2055 S Fremont Ave
Springfield MO 65804-2206
Phone: (417) 820-2468
Fax: (417) 820-7794
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | 2007018077 | Missouri |
Profile Details
| NPI number | 1558568618 |
|---|---|
| LBN Legal business name | Creach, Kimberly M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 29th, 2007 |
| Last updated | Oct 2nd, 2014 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558568618 | NPPES |
| Missouri | Other | 431560263 | TRICARE |
| Missouri | Other | P01089901 | TRICARE |
| Missouri | MEDICAID | 1558568618 | TRICARE |
| Missouri | MEDICAID | 193950001 | TRICARE |
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