Basic Information
| Provider Information | |||||||||
| NPI: | 1144463209 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DISHONGH | ||||||||
| FirstName: | KRISTIN | ||||||||
| MiddleName: | MITCHELL | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 N UNIVERSITY AVE | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722076347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016634116 | ||||||||
| FaxNumber: | 5016634301 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 N UNIVERSITY AVE | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722076347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016634116 | ||||||||
| FaxNumber: | 5016634301 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2009 | ||||||||
| LastUpdateDate: | 06/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | E-7890 | AR | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.