Provider Demographics
NPI:1275720443
Name:PRESLEY, KEVIN MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:MICHAEL
Last Name:PRESLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HOPE
Mailing Address - State:MO
Mailing Address - Zip Code:65725-8121
Mailing Address - Country:US
Mailing Address - Phone:417-267-2001
Mailing Address - Fax:
Practice Address - Street 1:209 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PLEASANT HOPE
Practice Address - State:MO
Practice Address - Zip Code:65725-8121
Practice Address - Country:US
Practice Address - Phone:417-267-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007022820207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine