GINA ZAREENA KHAN TILLEY MD NPI 1922230614

NPI Information

NPI: 1922230614
Provider Name: GINA ZAREENA KHAN TILLEY, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

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

Gina Zareena Khan Tilley, MD is a family medicine in Malvern, AR. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Gina Zareena Khan Tilley, MD NPI is 1922230614. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

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

The NPI 1922230614 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/14/2009 and was last updated on 12/22/2020.

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 Code	Taxonomy Clasification	License Number	License State	Primary
1	207Q00000X	Family Medicine	34139	OKLAHOMA	No
2	207Q00000X	Family Medicine	MD23125	MAINE	No
3	207Q00000X	Family Medicine	300283	NEW YORK	No
4	207Q00000X	Family Medicine	25MA10731900	NEW JERSEY	No
5	207Q00000X	Family Medicine	036.153880	ILLINOIS	No
6	207Q00000X	Family Medicine	61889	TENNESSEE	No
7	207Q00000X	Family Medicine	E-5303	ARKANSAS	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	179446001	MEDICAID	ARKANSAS

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: 4/28/2024

NPI Synchronization or Removal

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