Provider Demographics
NPI:1194969584
Name:KINDRICK, KRISTI MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:MARIE
Last Name:KINDRICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1001 TOWSON AVE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72901-4921
Mailing Address - Country:US
Mailing Address - Phone:479-441-5801
Mailing Address - Fax:479-441-4919
Practice Address - Street 1:7217 CAMERON PARK DR
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-6167
Practice Address - Country:US
Practice Address - Phone:479-831-6007
Practice Address - Fax:479-782-1242
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ606492084P0800X
ARE78782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR199257001Medicaid
AR199257001Medicaid