Individual
KIMO C STINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 CHILDRENS WAY # 512-10, LITTLE ROCK, AR 72202-3500
(501) 364-4374
(501) 364-6829
Mailing address
1 CHILDRENS WAY # 653, LITTLE ROCK, AR 72202-3500
(501) 364-1100
(501) 364-4082
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
N-8125
AR
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
N-8125
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120036001
—
AR
Enumeration date
10/13/2006
Last updated
07/09/2020
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