Provider Demographics
NPI:1174810782
Name:STAMBOUGH, KATHRYN CHRISTINE (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:CHRISTINE
Last Name:STAMBOUGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 CHILDRENS WAY # 653
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-364-1100
Mailing Address - Fax:501-364-4082
Practice Address - Street 1:1201 BISHOP ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-4627
Practice Address - Country:US
Practice Address - Phone:013-641-8495
Practice Address - Fax:501-364-6626
Is Sole Proprietor?:No
Enumeration Date:2011-07-03
Last Update Date:2019-10-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2015018675207VX0000X
NC201600638207V00000X
ARE-12216207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics