Provider Demographics
NPI:1356390546
Name:STILES, MICHAEL CRAIG (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CRAIG
Last Name:STILES
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 1:7200 W 129TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-2624
Mailing Address - Country:US
Mailing Address - Phone:913-897-9299
Mailing Address - Fax:914-897-3031
Practice Address - Street 1:7200 W 129TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-2624
Practice Address - Country:US
Practice Address - Phone:913-897-9299
Practice Address - Fax:914-897-3031
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0421479207W00000X
MOR3N76207W00000X
KS04-21479207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100131350DMedicaid
MOE64993Medicare UPIN
KS100131350DMedicaid
KS101950Medicare ID - Type Unspecified