Provider Demographics
NPI:1912901620
Name:TRANUM, BILLY LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:BILLY
Middle Name:LYNN
Last Name:TRANUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9501 LILE DR
Mailing Address - Street 2:STE 700
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6232
Mailing Address - Country:US
Mailing Address - Phone:501-223-8003
Mailing Address - Fax:501-223-8005
Practice Address - Street 1:9501 LILE DR
Practice Address - Street 2:STE 700
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6232
Practice Address - Country:US
Practice Address - Phone:501-223-8003
Practice Address - Fax:501-223-8005
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR-1839174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR55366Medicare ID - Type Unspecified
ARB90632Medicare UPIN