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TILLEY DIAGNOSTIC CLINIC NPI 1831108331


NPI Information

NPI: 1831108331
Provider Name: TILLEY DIAGNOSTIC CLINIC

Doing Business As: PINNACLE PHYSICIANS GROUP

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 04D0918880

Address:
1003 SCHNEIDER DR
MALVERN, AR
ZIP 72104
Phone: (501) 337-5678
Get Directions

TILLEY DIAGNOSTIC CLINIC is an internal medicine in Malvern, AR. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. TILLEY DIAGNOSTIC CLINIC NPI is 1831108331. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Pinnacle Physicians Group.

The provider's business location address is:

1003 SCHNEIDER DR
MALVERN, AR
ZIP 72104-811
Phone: (501) 337-5678
Fax: (501) 332-6759

The provider's authorized official is Absalom H Tilley .
The authorized official title is Owner and has the following contact phone number (501) 337-5678.

The CLIA number assigned to this NPI record is 04D0918880 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/5/2006 and was last updated on 12/9/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineC7758ARKANSASYes
2207RR0500XInternal MedicineRheumatologyE5172ARKANSASNo
3208000000XPediatricsE5062ARKANSASNo
4363A00000XPhysician AssistantGL008ARKANSASNo
5363L00000XNurse PractitionerP01341ARKANSASNo
6363LF0000XNurse PractitionerFamilyA01943ARKANSASNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1149122002MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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