Glennon, Timothy Christopher

Glennon, Timothy Christopher is an individual health care provider with primary practice located at 4140 Centennial Hills Blvd Suite A, Casper WY 82609. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Glennon, Timothy Christopher can be contacted via phone (307) 265-7205.

Contact Information

Primary practice address
4140 Centennial Hills Blvd Suite A Casper WY 82609
Phone: (307) 265-7205
Fax: (307) 235-6262
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA200064 Louisiana
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X TL556 Wyoming

Profile Details

NPI number 1447286943
LBN Legal business name Glennon, Timothy Christopher
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2006
Last updated Jul 11th, 2018 - about 7 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 1447286943 NPPES
Louisiana MEDICAID 1363839

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