Healthcare Provider Details

I. General information

NPI: 1427493618
Provider Name (Legal Business Name): TIMOTHY ONARECKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2013
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 COUNTRY CLUB ROAD
SHERWOOD AR
72120-5076
US

IV. Provider business mailing address

1525 COUNTRY CLUB ROAD
SHERWOOD AR
72120-5076
US

V. Phone/Fax

Practice location:
  • Phone: 501-758-1530
  • Fax: 501-819-6171
Mailing address:
  • Phone: 501-758-1530
  • Fax: 501-819-6171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberE-12347
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: