| Saline Medical Group | |
|
624 Alcoa Benton AR 72015-3404 | |
| (501) 315-4512 | |
| (501) 315-0917 |
| Full Name | Saline Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 624 Alcoa, Benton, Arkansas |
| Authorized Official Name and Position | Roger L Tilley (OWNER) |
| Authorized Official Contact | 5013154512 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Saline Medical Group 624 Alcoa Benton AR 72015-3404 Ph: (501) 315-4512 | Saline Medical Group 624 Alcoa Benton AR 72015-3404 Ph: (501) 315-4512 |
| NPI Number | 1700830718 |
|---|---|
| Provider Enumeration Date | 05/22/2006 |
| Last Update Date | 02/15/2016 |
| Medicare PECOS PAC ID | 3375440514 |
|---|---|
| Medicare Enrollment ID | O20090917000518 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700830718 | NPI | - | NPPES |
| 105459002 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Roger L Tilley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548366354 PECOS PAC ID: 6901703149 Enrollment ID: I20090917000532 |
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