Individual
DR. STEPHEN B TILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5905 R ST, LITTLE ROCK, AR 72207
(501) 663-9415
(501) 663-1874
Mailing address
701 N UNIVERSITY, SUITE 201, LITTLE ROCK, AR 72205
(501) 224-1690
(501) 224-1927
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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