Individual
TIMOTHY MICHAEL REARDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
166 FORREST LAKE DR, EL DORADO, AR 71730-3443
(678) 977-5094
Mailing address
166 FORREST LAKE DR, EL DORADO, AR 71730-3443
(678) 977-5094
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
120049
AR
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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