Individual
JAMES BRADLEY TILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
495 HOGAN RD, STE 1, CONWAY, AR 72034
(501) 327-1150
(501) 327-3427
Mailing address
495 HOGAN RD, STE 1, CONWAY, AR 72034
(501) 327-1150
(501) 327-3427
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
E-2822
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146509001
—
AR
Enumeration date
03/16/2006
Last updated
12/04/2009
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