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Individual

DR. KIRK D STITES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6801 ROGERS AVE, FORT SMITH, AR 72903-4067
(479) 274-4700
(479) 274-4799
Mailing address
PO BOX 3528, FORT SMITH, AR 72913-3528
(479) 274-2000
(479) 274-2160

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
17840
OK
207RC0000X
Cardiovascular Disease Physician
Primary
E1329
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100074580A
OK
05
131755001
AR
01
P00392123
RR MEDICARE
Enumeration date
10/04/2005
Last updated
04/17/2013
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