Provider Demographics
NPI:1215983937
Name:STIMPSON, KIM D (MD)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:D
Last Name:STIMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:350 HERITAGE WAY
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901
Mailing Address - Country:US
Mailing Address - Phone:406-752-6784
Mailing Address - Fax:406-756-4111
Practice Address - Street 1:350 HERITAGE WAY
Practice Address - Street 2:SUITE 1200
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901
Practice Address - Country:US
Practice Address - Phone:406-752-6784
Practice Address - Fax:406-756-4111
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT11011207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1215983937Medicaid
MT1215983937OtherBCBS
MT1215983937OtherBCBS