Provider Demographics
NPI:1215224704
Name:KWO, AGNES V (MD)
Entity Type:Individual
Prefix:DR
First Name:AGNES
Middle Name:V
Last Name:KWO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1000 WALDRON RD
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903
Mailing Address - Country:US
Mailing Address - Phone:479-221-9922
Mailing Address - Fax:479-221-9988
Practice Address - Street 1:1000 WALDRON RD
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903
Practice Address - Country:US
Practice Address - Phone:479-221-9922
Practice Address - Fax:479-221-9988
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE-8069207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine