Provider Demographics
NPI:1770745523
Name:PATTON, KRISTIN (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:PATTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:DOFFING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-3729
Mailing Address - Country:US
Mailing Address - Phone:501-778-4862
Mailing Address - Fax:501-778-4685
Practice Address - Street 1:5 MEDICAL PARK DR
Practice Address - Street 2:SUITE 102
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-3729
Practice Address - Country:US
Practice Address - Phone:501-778-4862
Practice Address - Fax:501-778-4685
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST-2139208600000X
IL036133188208600000X
ARE-9576208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery