Provider Demographics
NPI:1750489811
Name:KINGSTON, CAROLINE (MD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:KINGSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:460 SAINT MICHAELS DR
Mailing Address - Street 2:SUITE 1104
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7619
Mailing Address - Country:US
Mailing Address - Phone:505-820-2562
Mailing Address - Fax:505-795-7123
Practice Address - Street 1:460 SAINT MICHAELS DR
Practice Address - Street 2:SUITE 1104
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7619
Practice Address - Country:US
Practice Address - Phone:505-820-2562
Practice Address - Fax:505-795-7123
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM97-89207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine