Mckenna, Timothy Melvin

Mckenna, Timothy Melvin is an individual health care provider with primary practice located at 1675 Watertower Place Suite 100, East Lansing MI 48823. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Mckenna, Timothy Melvin can be contacted via phone (517) 332-0200.

Contact Information

Primary practice address
1675 Watertower Place Suite 100 East Lansing MI 48823
Phone: (517) 332-0200
Fax: (517) 332-0963
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 5101007174 Michigan

Profile Details

NPI number 1558352294
LBN Legal business name Mckenna, Timothy Melvin
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Aug 22nd, 2011 - about 14 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 1558352294 NPPES
Michigan MEDICAID 1544295

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