Provider Demographics
NPI:1679530679
Name:BAGBY-STONE, STEPHANIE D (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:D
Last Name:BAGBY-STONE
Suffix:
Gender:F
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:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:3 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-5276
Practice Address - Country:US
Practice Address - Phone:573-882-2511
Practice Address - Fax:573-884-1070
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20030070322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209298900Medicaid
MO209298900Medicaid
MO671626OtherHEALTHLINK
MO191200OtherBLUE CHOICE
I19872Medicare UPIN
MO671626OtherHEALTHLINK
MO191200OtherBLUE SHIELD