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General NPI Number Information
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NPI Number | 1588059430
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Entity Type | Individual
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Provider Name | KAITLYN MARIE PAINE MD
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Gender | Female
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Dates
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Enumeration Date | 03/30/2015
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 1695 E RAINFOREST RD
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-5385
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Country | US
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Telephone | 479-445-6460
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Fax |
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Provider Business Mailing Address
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Address Line | 1695 E RAINFOREST RD
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-5385
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Country | US
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Telephone | 479-445-6460
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 25MA11233000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 69381
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 312382
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | E-15817
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License Number State | AR
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