Diller, Timothy A

Diller, Timothy A is an individual health care provider with primary practice located at 1400 Braden St Emergency Dept, Jacksonville AR 72076-3721. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Diller, Timothy A can be contacted via phone (501) 985-7000.

Contact Information

Primary practice address
1400 Braden St Emergency Dept Jacksonville AR 72076-3721
Phone: (501) 985-7000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 4301044283 Michigan
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X T2007-006 Arkansas

Profile Details

NPI number 1205899481
LBN Legal business name Diller, Timothy A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Jun 19th, 2012 - about 12 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 1205899481 NPPES
Arkansas Other 786546 HEALTHLINK
Arkansas Other P01027351 HEALTHLINK
Arkansas Other 07100015600 HEALTHLINK
Arkansas Other 5086184 HEALTHLINK
Arkansas MEDICAID 164478001 HEALTHLINK

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