Provider Demographics
NPI:1720420037
Name:KINDY, ERIN (OD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:KINDY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 NATCHEZ PT APT 27
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-0953
Mailing Address - Country:US
Mailing Address - Phone:479-903-2411
Mailing Address - Fax:
Practice Address - Street 1:1401 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3317
Practice Address - Country:US
Practice Address - Phone:479-636-2012
Practice Address - Fax:479-631-7416
Is Sole Proprietor?:No
Enumeration Date:2013-07-28
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3126152W00000X
AR2697152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist