Tilley, Roger L

Tilley, Roger L is an individual health care provider with primary practice located at 624 Alcoa , Benton AR 72015-3404. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Tilley, Roger L can be contacted via phone (501) 315-4512.

Contact Information

Primary practice address
624 Alcoa Benton AR 72015-3404
Phone: (501) 315-4512
Fax: (501) 315-0917
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X C5458 Arkansas
Allopathic & Osteopathic Physicians / General Practice 208D00000X C5458 Arkansas

Profile Details

NPI number 1548366354
LBN Legal business name Tilley, Roger L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 16th, 2006
Last updated Oct 20th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548366354 NPPES
Arkansas MEDICAID 105495001

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