Doctor Name: | DR. STEPHEN M. KILLINGSWORTH |
NPI Number: | 1013985969 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | C6433 |
Business Practice Address: | 200 N Quanah Ave Russellville, AR - 728012762 |
Business Phone Number: | 4798900368 |
Business Fax Number: | 4798907368 |
Mailing Address: | 200 N Quanah Ave, RUSSELLVILLE |
State: | AR |
Postal Code: | 728012762 |
Phone Number: | 4798900368 |
Fax Number: | 4798907368 |
NPI Enumeration Date: | 03/08/2006 |
NPI Last Update Date: | 12/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207YX0905X |
License Number: | C6433 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Otolaryngology |
Taxonomy Specialization: | Otolaryngology/Facial Plastic Surgery |
Taxonomy Definition: | An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |