Individual
LARRY R KILLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
606 WILBUR D MILLS NORTH, KENSETT, AR 72082
(501) 742-5697
(501) 742-3031
Mailing address
623 N 9TH STREET, PO BOX 497, AUGUSTA, AR 72006
(870) 347-3300
(870) 347-3492
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C2942
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103621001
—
AR
Enumeration date
04/25/2006
Last updated
05/31/2011
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