# WH KS MEDICAL LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033973037
- **Authorized official:** JULIA STOVER (ENROLLMENT MANAGER)
- **Authorized official phone:** (903) 280-6679

## Contact information

- **Practice address:** 702 SW 8TH STREET, MAIL STOP 0445, BENTONVILLE, AR 72716-6209
- **Practice address phone:** (479) 360-0304
- **Mailing address:** 702 SW 8TH STREET, MAIL STOP 0445, BENTONVILLE, AR 72716-6209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | — | — |
| 103T00000X | Psychologist | — | — | — |
| 104100000X | Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/09/2024
- **Last updated:** 02/09/2024