Kientz, John L
Kientz, John L is an sole proprietor health care provider with primary practice located at 1500 Dodson Ave Ste 180, Fort Smith AR 72901-5182. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Kientz, John L can be contacted via phone (479) 709-7445.Contact Information
Primary practice address
1500 Dodson Ave Ste 180
Fort Smith AR 72901-5182
Phone: (479) 709-7445
Fax: (479) 573-7849
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | C4888 | Arkansas |
Profile Details
NPI number | 1568450393 |
---|---|
LBN Legal business name | Kientz, John L |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Oct 6th, 2005 |
Last updated | Aug 5th, 2016 - about 8 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1568450393 | NPPES |
Arkansas | MEDICAID | 105772001 | |
Arkansas | MEDICAID | 100076220A |
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