Individual
DR. TIMOTHY C WAACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6801 ROGERS AVE, FORT SMITH, AR 72903-4067
(479) 274-4700
(479) 274-4799
Mailing address
PO BOX 3528, FORT SMITH, AR 72913-3528
(479) 274-2000
(479) 274-2194
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
N-8026
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060010077
RR MEDICARE
—
05
—
117998001
—
AR
Enumeration date
08/05/2006
Last updated
09/01/2015
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