Twin Lakes Medical Specialists, PA

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

TWIN LAKES MEDICAL SPECIALISTS, PA

Practice address

628 Hospital Drive Ground Floor
Suite a
Mountain Home, AR 72653-2953

Phone

(870) 425-4402

Fax

(870) 425-6811

NPI assigned

May 12, 2006

Last updated

Nov 25, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

William S Dyer, M.D.

Title

Secretary/Owner

Phone

(870) 425-4402

Specialties & licenses 4

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448409600000",
    "number": "1275584575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 HOSPITAL DRIVE GROUND FLOOR",
            "address_2": "SUITE A",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532953",
            "telephone_number": "870-425-4402",
            "fax_number": "870-424-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 HOSPITAL DRIVE GROUND FLOOR",
            "address_2": "SUITE A",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532953",
            "telephone_number": "870-425-4402",
            "fax_number": "870-425-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN LAKES MEDICAL SPECIALISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2015-11-25",
        "status": "A",
        "authorized_official_last_name": "DYER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SECRETARY/OWNER",
        "authorized_official_telephone_number": "870-425-4402",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121749002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Traci R Garringer, Inc
• Travis D Richardson, DO, PLLC
• Belinda Rae Tucker, CPM, LM
• Karlee Tucker
• Joe Mitchell Tullis, MD
• Twin Lakes Physician Group PA
• Twin Lakes Surgery Center, LLC
• Twin River Community Living Facility
• Twin Rivers Respiratory Care, Inc. (AeroCare Home Medical)
• Elisa J. Tyler, MHPP

• Specialist in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• Specialist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.