Individual
DR. STEPHEN M. KILLINGSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 N QUANAH AVE, RUSSELLVILLE, AR 72801-2762
(479) 890-0368
(479) 890-7368
Mailing address
200 N QUANAH AVE, RUSSELLVILLE, AR 72801-2762
(479) 890-0368
(479) 890-7368
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
C6433
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105349001
—
AR
01
—
52878
ARKANSAS BCBS
AR
Enumeration date
03/08/2006
Last updated
12/15/2010
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