# TIM WILKIN D.O., P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fordyce Family Medical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780981498
- **Authorized official:** TIM T WILKIN D.O. (OWNER)
- **Authorized official phone:** (870) 247-8900

## Contact information

- **Practice address:** 8608 DOLLARWAY RD, SUITE C, WHITE HALL, AR 71602-2814
- **Practice address phone:** (870) 247-8900
- **Practice address fax:** (870) 247-8903
- **Mailing address:** 8608 DOLLARWAY RD, SUITE C, WHITE HALL, AR 71602-2814
- **Mailing address phone:** (870) 247-8900
- **Mailing address fax:** (870) 247-8903

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/15/2011
- **Last updated:** 09/26/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 131533003 | — | AR |
| 01 | — | 5K460 | BLUE CROSS BLUE SHIELD/MEDICARE | — |