Brady, Timothy Tobin

Brady, Timothy Tobin is an individual health care provider with primary practice located at 10012 Kennerly Rd Ste 101, St Louis MO 63128. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Brady, Timothy Tobin can be contacted via phone (314) 543-5200.

Contact Information

Primary practice address
10012 Kennerly Rd Ste 101 St Louis MO 63128
Phone: (314) 543-5200
Fax: (314) 543-5219
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X R9C27 Missouri

Profile Details

NPI number 1518056258
LBN Legal business name Brady, Timothy Tobin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2006
Last updated Aug 16th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518056258 NPPES
Missouri MEDICAID 202249520

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