Individual
TIMOTHY Y. MARYANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9616 ROGERS AVE, FORT SMITH, AR 72903-5769
(479) 242-3310
(479) 439-8868
Mailing address
9616 ROGERS AVE, FORT SMITH, AR 72903-5769
(479) 551-2127
(479) 439-8868
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
E7752
AR
207T00000X
Neurological Surgery Physician
LL33444
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195532001
—
AR
Enumeration date
04/26/2007
Last updated
02/28/2023
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