| Tilley Family Medicine, Pa | |
|
495 Hogan Ln Suite 1 Conway AR 72034-8201 | |
| (501) 327-1150 | |
| (501) 327-3427 |
| Full Name | Tilley Family Medicine, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 495 Hogan Ln, Conway, Arkansas |
| Authorized Official Name and Position | Brenda Leigh Stone (OFFICE MANAGER) |
| Authorized Official Contact | 5013271150 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tilley Family Medicine, Pa 495 Hogan Ln Suite 1 Conway AR 72034-8201 Ph: (501) 327-1150 | Tilley Family Medicine, Pa 495 Hogan Ln Suite 1 Conway AR 72034-8201 Ph: (501) 327-1150 |
| NPI Number | 1679581730 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 09/14/2015 |
| Medicare PECOS PAC ID | 8224012505 |
|---|---|
| Medicare Enrollment ID | O20040615000739 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679581730 | NPI | - | NPPES |
| 134809002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | James B Tilley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932178332 PECOS PAC ID: 4385606375 Enrollment ID: I20100803001299 |
| Provider Name | Nichole D Paladino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295032514 PECOS PAC ID: 1254519416 Enrollment ID: I20110617000437 |
| Provider Name | Amber N Tilley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790058709 PECOS PAC ID: 3577725266 Enrollment ID: I20120425000343 |
| Provider Name | Rhonda C Robnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275780736 PECOS PAC ID: 0547404519 Enrollment ID: I20130912000330 |
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