Gardner, Timothy Logan

Gardner, Timothy Logan is an sole proprietor health care provider with primary practice located at 8930 Cross Park Dr Ste 2 , Knoxville TN 37923-4713. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Gardner, Timothy Logan can be contacted via phone (865) 218-7474.

Contact Information

Primary practice address
8930 Cross Park Dr Ste 2 Knoxville TN 37923-4713
Phone: (865) 218-7474
Fax: (865) 218-7475
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X DPM 409 Tennessee

Profile Details

NPI number 1841249224
LBN Legal business name Gardner, Timothy Logan
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 10th, 2006
Last updated Apr 26th, 2022 - about 2 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 1841249224 NPPES
Kentucky MEDICAID 80002017
Kentucky MEDICAID 3351921
Kentucky Other 000000053556
Kentucky Other 0191729

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