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Organization
THE DIETITIAN DOCTOR, LLC
Active
Organization
THE DIETITIAN DOCTOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KINDANN MCMAHAN STONE FAWCETT PHD, RD, LD (CEO/OWNER)
(501) 605-0310
Entity
Organization
Contact information
Practice address
305 E MAIN ST, CABOT, AR 72023-3034
(501) 605-0310
(501) 605-0325
Mailing address
PO BOX 100, AUSTIN, AR 72007-0100
(501) 605-3683
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
11/27/2023
Last updated
04/10/2024
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