=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871794974
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TIMOTHY KYLE FINCHER R.PH., PH.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/29/2007
-----------------------------------------------------
Last Update Date | 06/05/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10901 N RODNEY PARHAM RD
-----------------------------------------------------
City | LITTLE ROCK
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72212-4114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-227-0131
-----------------------------------------------------
Fax | 501-227-0954
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10901 N RODNEY PARHAM RD
-----------------------------------------------------
City | LITTLE ROCK
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72212-4114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-227-0131
-----------------------------------------------------
Fax | 501-227-0395
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 9462
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------