Provider Demographics
NPI:1326086323
Name:COWHERD, KRISTY CLINTON (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:CLINTON
Last Name:COWHERD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1678
Mailing Address - Street 2:
Mailing Address - City:HEBER SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72543-1678
Mailing Address - Country:US
Mailing Address - Phone:501-362-0500
Mailing Address - Fax:501-362-0501
Practice Address - Street 1:20 BAPTIST HEALTH DR
Practice Address - Street 2:
Practice Address - City:HEBER SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72543-8765
Practice Address - Country:US
Practice Address - Phone:501-362-0500
Practice Address - Fax:501-362-0501
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2384207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1670438003OtherCIGNA NUMBER
AR18871000000OtherQUALCHOICE NUMBER
AR5L376OtherBCBS NUMBER
AR7357320OtherAETNA NUMBER
AR139303001Medicaid
ARAP006004OtherHUMANA NUMBER
ARP00017020OtherRAILROAD MEDICARE NUMBER
AR731667341-72543-A002OtherTRICARE NUMBER
AR7357320OtherAETNA NUMBER
ARP00017020OtherRAILROAD MEDICARE NUMBER