Provider Demographics
NPI:1326245218
Name:STALLINGS-ARCHER, KANDI ALICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:KANDI
Middle Name:ALICIA
Last Name:STALLINGS-ARCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KANDI
Other - Middle Name:ALICIA
Other - Last Name:STALLINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:700 CHILDRENS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2664
Mailing Address - Country:US
Mailing Address - Phone:614-722-5720
Mailing Address - Fax:
Practice Address - Street 1:700 CHILDRENS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2664
Practice Address - Country:US
Practice Address - Phone:614-722-5720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH99329207ZP0102X
NE26533207ZP0102X
ARE-8064207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology