Basic Information
| Provider Information | |||||||||
| NPI: | 1659548790 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KINNEY | ||||||||
| FirstName: | DANA | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1449 | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN HOME | ||||||||
| State: | AR | ||||||||
| PostalCode: | 726541449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8704243181 | ||||||||
| FaxNumber: | 8704243089 | ||||||||
| Practice Location | |||||||||
| Address1: | 624 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN HOME | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72653 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8705081000 | ||||||||
| FaxNumber: | 8704243089 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2008 | ||||||||
| LastUpdateDate: | 02/19/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | E-7226 | AR | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.