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8608 Dollarway Rd Suite C White Hall AR 71602-2814 | |
(870) 247-8900 | |
(870) 247-8903 |
Full Name | |
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Speciality | Family Medicine |
Location | 8608 Dollarway Rd, White Hall, Arkansas |
Authorized Official Name and Position | Tim T Wilkin (OWNER) |
Authorized Official Contact | 8702478900 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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8608 Dollarway Rd Suite C White Hall AR 71602-2814 Ph: (870) 247-8900 | 8608 Dollarway Rd Suite C White Hall AR 71602-2814 Ph: (870) 247-8900 |
NPI Number | 1780981498 |
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Provider Enumeration Date | 02/15/2011 |
Last Update Date | 09/26/2014 |
Medicare PECOS PAC ID | 2365627569 |
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Medicare Enrollment ID | O20110504000197 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780981498 | NPI | - | NPPES |
5K460 | Other | BLUE CROSS BLUE SHIELD/MEDICARE | |
131533003 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Timothee T Wilkin |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1225188121 PECOS PAC ID: 7810984390 Enrollment ID: I20040427001129 |
Primary Care 360 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Frankie Ln, White Hall, AR 71602 Phone: 870-393-5050 | |
Jefferson Hospital Association, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1600 W Holland Ave Ste 202, White Hall, AR 71602 Phone: 870-541-7235 Fax: 870-541-4297 | |
White Hall Walk In Clinic Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7250 Sheridan Rd, White Hall, AR 71602 Phone: 870-247-2779 Fax: 870-247-2780 | |