Provider Demographics
NPI:1194282822
Name:KION PEDIATRICS
Entity type:Organization
Organization Name:KION PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:I
Authorized Official - Last Name:NWOKEJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-333-5466
Mailing Address - Street 1:3410 E JOHNSON AVE STE T
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-2032
Mailing Address - Country:US
Mailing Address - Phone:870-333-5466
Mailing Address - Fax:870-333-1026
Practice Address - Street 1:3410 E JOHNSON AVE STE T
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-2032
Practice Address - Country:US
Practice Address - Phone:870-333-5466
Practice Address - Fax:870-336-1026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty