Healthcare Provider Details

I. General information

NPI: 1114782745
Provider Name (Legal Business Name): ALEXANDER ALI TYLER-HASHEMI MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2024
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 CARL DR APT 57
HOT SPRINGS AR
71913-6255
US

IV. Provider business mailing address

2605 COLLINS DR
CONWAY AR
72034-9687
US

V. Phone/Fax

Practice location:
  • Phone: 501-651-2000
  • Fax:
Mailing address:
  • Phone: 912-247-5495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER TYLER
Title or Position: OWNER OF ENTITY
Credential: MD
Phone: 501-651-2000