Provider Demographics
NPI:1467450577
Name:FLURY, KIRK E (MD)
Entity Type:Individual
Prefix:DR
First Name:KIRK
Middle Name:E
Last Name:FLURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 DOUGHERTY FERRY RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-3383
Mailing Address - Country:US
Mailing Address - Phone:314-977-4701
Mailing Address - Fax:314-977-9637
Practice Address - Street 1:2315 DOUGHERTY FERRY RD
Practice Address - Street 2:SUITE 205
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-3383
Practice Address - Country:US
Practice Address - Phone:314-977-4701
Practice Address - Fax:314-977-9637
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR2C57207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA09765Medicare UPIN