Kenneth Tonymon, MD | |
2900 Medical Center Pkwy Ste 220, Bentonville, AR 72712-3213 | |
(479) 696-0966 | |
(479) 418-5330 |
Full Name | Kenneth Tonymon |
---|---|
Gender | Male |
Speciality | Neurological Surgery |
Location | 2900 Medical Center Pkwy Ste 220, Bentonville, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164472072 | NPI | - | NPPES |
287021002 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207T00000X | Neurological Surgery | 14822 (North Dakota) | Secondary |
207T00000X | Neurological Surgery | C5586 (Arkansas) | Primary |
Entity Name | Northwest Physicians Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194768721 PECOS PAC ID: 0244213213 Enrollment ID: O20040610000882 |
Entity Name | Fort Smith Hma Pbc Management Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477888907 PECOS PAC ID: 8224172127 Enrollment ID: O20100216000383 |
Entity Name | Tonymon Neuro Spine Clinic Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396483673 PECOS PAC ID: 6002298551 Enrollment ID: O20220801002262 |
Mailing Address | Practice Location Address |
---|---|
Kenneth Tonymon, MD Po Box 8490, Fayetteville, AR 72703-0009 Ph: (870) 926-5010 | Kenneth Tonymon, MD 2900 Medical Center Pkwy Ste 220, Bentonville, AR 72712-3213 Ph: (479) 696-0966 |
Richard Slater Kyle, M.D. Neurological Surgery Medicare: Not Enrolled in Medicare Practice Location: 1502 Se 28th St, Suite 2, Bentonville, AR 72712 Phone: 479-273-1220 |