Individual
TIMOTHY WAYNE YAWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1615W PERSIMMON ST B, ROGERS, AR 72756-3383
(479) 636-7192
(479) 631-8212
Mailing address
1615 W PERSIMMON ST, ROGERS, AR 72756-3383
(479) 636-7192
(479) 621-9749
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C7558
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080050005
RAILROAD MEDICARE
AR
05
—
115750001
—
AR
01
—
52435
BLUE CROSS BLUE SHIELD
AR
Enumeration date
02/08/2006
Last updated
10/16/2015
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