Herndon, Timothy E
Herndon, Timothy E is an individual health care provider with primary practice located at 4351 E Lohman Ave Suite 100, Las Cruces NM 88011-8259. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Herndon, Timothy E can be contacted via phone (575) 532-9077.Contact Information
Primary practice address
4351 E Lohman Ave Suite 100
Las Cruces NM 88011-8259
Phone: (575) 532-9077
Fax: (575) 532-9221
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 82-210 | New Mexico |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | M-13463 | Idaho |
Profile Details
| NPI number | 1164400354 |
|---|---|
| LBN Legal business name | Herndon, Timothy E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 6th, 2006 |
| Last updated | May 21st, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164400354 | NPPES |
| New Mexico | MEDICAID | 23209259 |
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