Individual
KENNETH TONYMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2900 MEDICAL CENTER PKWY STE 220, BENTONVILLE, AR 72712-3213
(479) 696-0966
(479) 418-5330
Mailing address
PO BOX 8490, FAYETTEVILLE, AR 72703-0009
(870) 926-5010
(479) 301-2111
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
14822
ND
207T00000X
Neurological Surgery Physician
Primary
C5586
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287021002
—
AR
Enumeration date
05/11/2006
Last updated
05/11/2023
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