Individual
DR. KIPP ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2100 N 62ND ST, FORT SMITH, AR 72904-5163
(479) 782-0606
Mailing address
2100 N 62ND ST, FORT SMITH, AR 72904-5163
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD14209
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PD14209
ARKANSAS STATE BOARD LICENSE NUMBER
AR
Enumeration date
09/22/2017
Last updated
09/22/2017
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