# TILLEY DIAGNOSTIC CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pinnacle Physicians Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831108331
- **Authorized official:** ABSALOM H TILLEY M.D. (OWNER)
- **Authorized official phone:** (501) 337-5678

## Contact information

- **Practice address:** 1003 SCHNEIDER DR, MALVERN, AR 72104-4811
- **Practice address phone:** (501) 337-5678
- **Practice address fax:** (501) 332-6759
- **Mailing address:** 1003 SCHNEIDER DR, MALVERN, AR 72104-4811
- **Mailing address phone:** (501) 337-5678
- **Mailing address fax:** (501) 332-6759

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | C7758 | AR | Yes |
| 207RR0500X | Rheumatology Physician | E5172 | AR | — |
| 208000000X | Pediatrics Physician | E5062 | AR | — |
| 363A00000X | Physician Assistant | GL008 | AR | — |
| 363L00000X | Nurse Practitioner | P01341 | AR | — |
| 363LF0000X | Family Nurse Practitioner | A01943 | AR | — |

## Other

- **Enumeration date:** 08/05/2006
- **Last updated:** 12/09/2020