| Doctor Name: | JAMES BRADLEY TILLEY |
| NPI Number: | 1932178332 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | E-2822 |
| Business Practice Address: | 495 Hogan Rd, Ste 1 Conway, AR - 72034 |
| Business Phone Number: | 5013271150 |
| Business Fax Number: | 5013273427 |
| Mailing Address: | 495 Hogan Rd, Ste 1, CONWAY |
| State: | AR |
| Postal Code: | 72034 |
| Phone Number: | 5013271150 |
| Fax Number: | 5013273427 |
| NPI Enumeration Date: | 03/16/2006 |
| NPI Last Update Date: | 12/04/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | E-2822 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |