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General NPI Number Information
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NPI Number | 1366195505
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Entity Type | Organization
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Legal Business Name | KION PEDIATRICS
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Dates
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Enumeration Date | 01/28/2022
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 2101 MALCOLM AVE STE 101
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City | NEWPORT
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State | AR
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Zip | 72112-3631
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Country | US
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Telephone | 870-523-5466
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Fax | 870-495-1166
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Provider Business Mailing Address
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Address Line | 2101 MALCOLM AVE STE 101
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City | NEWPORT
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State | AR
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Zip | 72112-3631
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Country | US
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Telephone | 870-523-5466
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Fax |
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Authorized Official
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Title or Position | DR
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Name | DR. KRIS NWOKEJI
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Credential | MD
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Telephone | 870-523-5466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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