Kienstra, Matthew A

Kienstra, Matthew A is an individual health care provider with primary practice located at 1965 S Fremont Ave Suite 120, Springfield MO 65804-2201. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Facial Plastic Surgery. Allopathic & Osteopathic Physicians / Facial Plastic Surgery is his primary health care specialty. Kienstra, Matthew A can be contacted via phone (417) 887-3223.

Contact Information

Primary practice address
1965 S Fremont Ave Suite 120 Springfield MO 65804-2201
Phone: (417) 887-3223
Fax: (417) 820-3955
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 2006003278 Missouri
Allopathic & Osteopathic Physicians / Facial Plastic Surgery 207YS0123X 2006003278 Missouri

Profile Details

NPI number 1740329671
LBN Legal business name Kienstra, Matthew A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2007
Last updated May 6th, 2024 - about 2 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 1740329671 NPPES
Arkansas MEDICAID 160592001
Arkansas MEDICAID 200586204
Arkansas Other 204558
Arkansas Other 83878

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