Killingsworth, Stephen M.

Killingsworth, Stephen M. is an sole proprietor health care provider with primary practice located at 200 N Quanah Ave , Russellville AR 72801-2762. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery, which is considered as his primary health care specialty. Killingsworth, Stephen M. can be contacted via phone (479) 890-0368.

Contact Information

Primary practice address
200 N Quanah Ave Russellville AR 72801-2762
Phone: (479) 890-0368
Fax: (479) 890-7368
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery 207YX0905X C6433 Arkansas

Profile Details

NPI number 1013985969
LBN Legal business name Killingsworth, Stephen M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 8th, 2006
Last updated Dec 15th, 2010 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013985969 NPPES
Arkansas Other 52878 ARKANSAS BCBS
Arkansas MEDICAID 105349001 ARKANSAS BCBS

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