Provider Demographics
NPI:1295737559
Name:CARPINO, STEPHANIE J (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:J
Last Name:CARPINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CAWDOR LN
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72715-4511
Mailing Address - Country:US
Mailing Address - Phone:816-885-2147
Mailing Address - Fax:
Practice Address - Street 1:4301 GREATHOUSE SPRINGS RD
Practice Address - Street 2:
Practice Address - City:JOHNSON
Practice Address - State:AR
Practice Address - Zip Code:72762
Practice Address - Country:US
Practice Address - Phone:479-684-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE9955207V00000X
MOMD112093174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO160038214OtherMEDICARE RR
MO24399010OtherBCBS
MO160038214OtherMEDICARE RR
MOG86278Medicare UPIN