St. Clair, Kevin L
St. Clair, Kevin L is an individual health care provider with primary practice located at 4375 N Vantage Dr Suite 305, Fayetteville AR 72703-4982. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. St. Clair, Kevin L can be contacted via phone (479) 443-5100.Contact Information
Primary practice address
4375 N Vantage Dr Suite 305
Fayetteville AR 72703-4982
Phone: (479) 443-5100
Fax: (479) 443-5117
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | R4149 | Arkansas |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | R-4149 | Arkansas |
Profile Details
| NPI number | 1649357690 |
|---|---|
| LBN Legal business name | St. Clair, Kevin L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Nov 18th, 2021 - about 4 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 | 1649357690 | NPPES |
| Arkansas | MEDICAID | 119113001 | |
| Arkansas | Other | 16085000000 |
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