Provider Demographics
NPI:1699776195
Name:KUYKENDALL, MARGARET W (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:W
Last Name:KUYKENDALL
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 1:3443 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-8820
Mailing Address - Country:US
Mailing Address - Phone:870-698-1635
Mailing Address - Fax:870-793-3196
Practice Address - Street 1:3443 HARRISON ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-8820
Practice Address - Country:US
Practice Address - Phone:870-698-1635
Practice Address - Fax:870-793-3196
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC7767174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR128763001Medicaid
ARG17791Medicare UPIN
AR128763001Medicaid