Individual
DR. TIMOTHY PHILLIP TALON BURNSIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1120 E GERMAN LN, CONWAY, AR 72032-4555
(501) 329-3733
Mailing address
5618 B ST APT 4, LITTLE ROCK, AR 72205-3369
(479) 221-2476
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD14051
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PD14051
PHARMACIST LICENSE
AR
Enumeration date
07/07/2017
Last updated
07/07/2017
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