Timothy Y Maryanov (NPI# 1629298500, PAC ID# 5698943389) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEUROSURGERY.
| Nation Provider ID (NPI) | 1629298500 |
| PAC ID by PECOS | 5698943389 |
| Professional Enrollment ID | I20121105000285 |
| Full Name | Timothy Y Maryanov |
| Address |
1501 S Waldron Rd 109 Fort Neuro Fort Smith AR 72903-2568 |
| Phone Number | 4792423310 |
| Gender | M |
| Medical School | UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE |
| Graduation Year | 2004 |
| Primary Specialty | NEUROSURGERY |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 040018 | SPARKS MEDICAL CENTER VAN BUREN |
| Address | Phone | Organization |
|---|---|---|
| 1501 S Waldron Rd, 109 Fort Neuro, Fort Smith, AR 72903-2568 | 4792423310 |
| Street Address |
1501 S WALDRON RD 109 FORT NEURO |
| City | FORT SMITH |
| State | AR |
| Zip | 72903-2568 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Malcolm R Hutchins | Optometry | 5111 Rogers Ave, Suite 54, Fort Smith, AR 72903-2033 | |
| Kristen W Eckelhoff | Psychologist, Clinical | 5111 Rogers Ave, 526 Fort Smith Psychology, Fort Smith, AR 72903-2047 | |
| Dena Amerine Harris | Optometry | 4900 Rogers Ave, 103a, Fort Smith, AR 72903-2068 | |
| Wanda Vaughn | Optometry | 1021 S Waldron Rd, Fort Smith, AR 72903-2549 | |
| Kelly A Hokit | Nurse Practitioner | Mercy Clinic Fort Smith Communities | 1000 S Waldron Rd, Fort Smith, AR 72903-2550 |
| Jessiela Venis Roberts | Family Medicine | Mercy Clinic Fort Smith Communities | 1000 S Waldron Rd, Fort Smith, AR 72903-2550 |
| Thao Phuong Nguyen | Family Medicine | Mercy Clinic Fort Smith Communities | 1000 S Waldron Rd, Fort Smith, AR 72903-2550 |
| Vikki L Sutterfield | Family Medicine | Mercy Clinic Fort Smith Communities | 1000 S Waldron Rd, Fort Smith, AR 72903-2550 |
| Stefanie A Ellis | Nurse Practitioner | Mercy Clinic Fort Smith Communities | 1000 S Waldron Rd, Fort Smith, AR 72903-2550 |
| Joseph Lee Speake | Family Medicine | Mercy Clinic Fort Smith Communities | 1000 S Waldron Rd, Fort Smith, AR 72903-2550 |
| Find all physicians in zip 72903 | |||
| City | FORT SMITH |
| Zip Code | 72903 |
| Specialty | NEUROSURGERY |
| City + Specialty | FORT SMITH + NEUROSURGERY |
Please comment or provide details below to improve the information on Timothy Y Maryanov.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.