Tim Wilkin D.O., P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TIM WILKIN D.O., P.A.

Practice address

8608 Dollarway Rd
Suite C
White Hall, AR 71602-2814

Phone

(870) 247-8900

Fax

(870) 247-8903

NPI assigned

Feb 15, 2011

Organization subpart

No

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

Authorized official

Name

Tim T Wilkin, D.O.

Title

Owner

Phone

(870) 247-8900

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Fordyce Family Medical Former legal business name

Locations

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411689600000",
    "number": "1780981498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8608 DOLLARWAY RD",
            "address_2": "SUITE C",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716022814",
            "telephone_number": "870-247-8900",
            "fax_number": "870-247-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8608 DOLLARWAY RD",
            "address_2": "SUITE C",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716022814",
            "telephone_number": "870-247-8900",
            "fax_number": "870-247-8903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIM WILKIN D.O., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-15",
        "last_updated": "2014-09-26",
        "status": "A",
        "authorized_official_last_name": "WILKIN",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-247-8900",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD/MEDICARE",
            "identifier": "5K460",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131533003",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fordyce Family Medical",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Family Medicine Physician in White Hall, AR
• Providers in White Hall, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; 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.