Organization
TWIN LAKES MEDICAL SPECIALISTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM S DYER M.D. (SECRETARY/OWNER)
(870) 425-4402
Entity
Organization
Contact information
Practice address
628 HOSPITAL DRIVE GROUND FLOOR, SUITE A, MOUNTAIN HOME, AR 72653-2953
(870) 425-4402
(870) 425-6811
Mailing address
628 HOSPITAL DRIVE GROUND FLOOR, SUITE A, MOUNTAIN HOME, AR 72653-2953
(870) 425-4402
(870) 424-3089
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207RG0100X
Gastroenterology Physician
—
—
207RX0202X
Medical Oncology Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121749002
—
AR
Enumeration date
05/12/2006
Last updated
11/25/2015
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