Healthcare Provider Details

I. General information

NPI: 1558709261
Provider Name (Legal Business Name): TIM HENNESSEY PARMLEY II M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2013
Last Update Date: 06/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MEMORY LN
HATTIEVILLE AR
72063-8858
US

IV. Provider business mailing address

2 MEMORY LN
HATTIEVILLE AR
72063-8858
US

V. Phone/Fax

Practice location:
  • Phone: 501-477-2332
  • Fax:
Mailing address:
  • Phone: 501-477-2332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberR-3818
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: