Organization
STEPHEN M. KILLINGSWORTH, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN M. KILLINGSWORTH MD (OWNER)
(479) 890-0368
Entity
Organization
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132753002
—
AR
01
—
5F605
ARKANSAS BCBS
AR
Enumeration date
03/07/2006
Last updated
12/15/2010
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