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Individual
DR. STEPHEN B TILLEY
Active
Individual
DR. STEPHEN B TILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C4672
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-20334
UNITED HEALTHCARE
AR
01
—
11217000000
QUALCHOICE
AR
Enumeration date
06/30/2005
Last updated
04/17/2008
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