Provider Demographics
NPI:1750320792
Name:FLEEMAN, TIM ALAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:TIM
Middle Name:ALAN
Last Name:FLEEMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 OVERLAND TRL
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:AR
Mailing Address - Zip Code:71602-3248
Mailing Address - Country:US
Mailing Address - Phone:870-247-1338
Mailing Address - Fax:
Practice Address - Street 1:7197 SHERIDAN RD
Practice Address - Street 2:SUITE 109
Practice Address - City:WHITE HALL
Practice Address - State:AR
Practice Address - Zip Code:71602-3207
Practice Address - Country:US
Practice Address - Phone:870-247-3900
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR06728183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist