Clark, Timothy William Ingraham

Clark, Timothy William Ingraham is an individual health care provider with primary practice located at 51 N. 39Th Street , Philadelphia PA 19104. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Clark, Timothy William Ingraham can be contacted via phone (215) 662-3005.

Contact Information

Primary practice address
51 N. 39Th Street Philadelphia PA 19104
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X MD065636L Pennsylvania
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD065636L Pennsylvania

Profile Details

NPI number 1588629885
LBN Legal business name Clark, Timothy William Ingraham
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2006
Last updated Apr 18th, 2018 - about 6 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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