Root, Timothy D

Root, Timothy D is an individual health care provider with primary practice located at 345 N Clyde Morris Blvd Suite 330, Ormond Beach FL 32174-3114. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Root, Timothy D can be contacted via phone (386) 672-4244.

Contact Information

Primary practice address
345 N Clyde Morris Blvd Suite 330 Ormond Beach FL 32174-3114
Phone: (386) 672-4244
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 000487 Georgia

Profile Details

NPI number 1033322078
LBN Legal business name Root, Timothy D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2007
Last updated Jun 7th, 2012 - about 12 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 1033322078 NPPES
Florida MEDICAID 000475900

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