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NPI Code Detail

MEDICARE: DR. WILLIAM CLINT KINDRICK M.D.

MEDICARE: DR. WILLIAM CLINT KINDRICK M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianE-7817AR

General Provider Information

NPI Number : 1083858427
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM CLINT KINDRICK M.D.
Provider Business Mailing Address
First Line : 12023 RIDGEFIELD DR
Second Line :
City : FORT SMITH
State : AR
Zip : 72916-8419
Country : US
Telephone Number : 501-208-7676
Fax Number :
Provider Business Practice Location Address
First Line : 7217 CAMERON PARK DR
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-6167
Country : US
Telephone Number : 479-831-6007
Fax Number : 479-782-1242
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2009
Last Update Date : 10/09/2019

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