Individual
DR. KEVIN C KLEINSCHMIDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
418 N 2ND ST, ASHDOWN, AR 71822-2755
(870) 898-5037
(870) 898-4732
Mailing address
418 N 2ND ST, ASHDOWN, AR 71822-2755
(870) 898-5037
(870) 898-4732
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E0986
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04D0953144
CLIA
AR
05
—
12715600100
—
AR
01
—
5J650
BLUE CROSS
AR
01
—
861079386
TAX #
AR
01
—
AP.220001
TRICARE
AR
01
—
P00052246
RAILROAD MCR
AR
01
—
P00649786
MEDICARE RAILROAD CARRIER
AR
Enumeration date
07/31/2006
Last updated
02/25/2013
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