Koob, Timothy J

Koob, Timothy J is an individual health care provider with primary practice located at 5801 Research Park Blvd Ste 110, Madison WI 53719-6002. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Koob, Timothy J can be contacted via phone (608) 274-0770.

Contact Information

Primary practice address
5801 Research Park Blvd Ste 110 Madison WI 53719-6002
Phone: (608) 274-0770
Fax: (608) 274-9224
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 5109 Wisconsin

Profile Details

NPI number 1538104088
LBN Legal business name Koob, Timothy J
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2006
Last updated Jul 9th, 2007 - about 18 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 1538104088 NPPES
Wisconsin Other 12127 DEAN HEALTH PLAN
Wisconsin MEDICAID 33754500 DEAN HEALTH PLAN

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