Provider Demographics
NPI:1124128467
Name:PALMER, KRICIA P (MD)
Entity type:Individual
Prefix:
First Name:KRICIA
Middle Name:P
Last Name:PALMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3108 FOXCROFT RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-2303
Mailing Address - Country:US
Mailing Address - Phone:501-224-1726
Mailing Address - Fax:
Practice Address - Street 1:3108 FOXCROFT RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72227-2303
Practice Address - Country:US
Practice Address - Phone:501-224-1726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2008-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE48662080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR06080015700OtherQULCHOICE
AR163877001Medicaid
ARP00381023OtherRAILROAD MEDICARE
AR163877001Medicaid