Organization
SALINE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER L TILLEY MD (OWNER)
(501) 315-4512
Entity
Organization
Contact information
Practice address
624 ALCOA, BENTON, AR 72015-3404
(501) 315-4512
(501) 315-0917
Mailing address
624 ALCOA, BENTON, AR 72015-3404
(501) 315-4512
(501) 315-0917
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105459002
—
AK
Enumeration date
05/22/2006
Last updated
02/15/2016
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