Miles, Tim
Miles, Tim is an sole proprietor health care provider with primary practice located at 402 N Second Street , Grants NM 87020. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Miles, Tim can be contacted via phone (505) 285-2614.Contact Information
Primary practice address
402 N Second Street
Grants NM 87020
Phone: (505) 285-2614
Fax: (505) 287-8487
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / School | 103TS0200X | 287256 | New Mexico |
Profile Details
| NPI number | 1801921499 |
|---|---|
| LBN Legal business name | Miles, Tim |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 22nd, 2007 |
| Last updated | Jul 8th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801921499 | NPPES |
| New Mexico | MEDICAID | 32408714 |
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