Individual
KIM R AGEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3344 N FUTRALL DR, FAYETTEVILLE, AR 72703-4057
(479) 521-8200
(479) 582-7310
Mailing address
PO BOX 1523, FAYETTEVILLE, AR 72702-1523
(479) 521-8200
(479) 582-7310
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
C-6784
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5K140
AR BC/BS
AR
01
—
P00192576
RAILROAD MEDICARE
AR
Enumeration date
06/16/2006
Last updated
02/22/2008
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