Mathis, Timothy E
Mathis, Timothy E is an individual health care provider with primary practice located at 8383 Millicent Way , Shreveport LA 71115-5207. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mathis, Timothy E can be contacted via phone (318) 797-6661.Contact Information
Primary practice address
8383 Millicent Way
Shreveport LA 71115-5207
Phone: (318) 797-6661
Fax: (318) 795-8512
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 07536R | Louisiana |
Profile Details
| NPI number | 1730185927 |
|---|---|
| LBN Legal business name | Mathis, Timothy E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2005 |
| Last updated | May 8th, 2024 - about 6 months 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 | 1730185927 | NPPES |
| Louisiana | Other | 2712976009 | CIGNA |
| Louisiana | MEDICAID | 1376884 | CIGNA |
| Louisiana | Other | 5843480 | CIGNA |
| Louisiana | Other | 080039492 | CIGNA |
| Louisiana | Other | B005 | CIGNA |
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