Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Timothy John Dietrich, DO

Individual provider Internal Medicine Physician · NPI 1053654608

Dr. Timothy John Dietrich, DO is an Internal Medicine in Maumelle, Arkansas. Qualified in 2013, 13 years ago. Practices with Arkansas Health Group, a 645-clinician group and accepts Medicare assignment. Licensed in Arkansas.

Years since qualifying
13
Licensed in
AR
In the registry since
2013
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1705 Club Manor Dr Ste 2
Maumelle, AR 72113-7401
Phone: (501) 851-7402
Fax: (501) 851-4753
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence E-3259 (AR)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1053654608
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 2, 2013
Last updated in NPPESSeptember 2, 2016
Mailing address1701 Club Manor Drive, Suite 2, Maumelle, AR 72113-7401

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Arkansas Health Group — 645 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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