Siegel, Timothy R
Siegel, Timothy R is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd , Portland OR 97239. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is his primary health care specialty. Siegel, Timothy R can be contacted via phone (503) 494-6068.Contact Information
Primary practice address
3181 Sw Sam Jackson Park Rd
Portland OR 97239
Phone: (503) 494-6068
Fax: (503) 494-3495
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 15327 | New Hampshire |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 0101257693 | Virginia |
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 2086H0002X | 0101257693 | Virginia |
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 2086H0002X | 15327 | New Hampshire |
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 2086H0002X | MD183891 | Oregon |
Profile Details
| NPI number | 1619931870 |
|---|---|
| LBN Legal business name | Siegel, Timothy R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 14th, 2006 |
| Last updated | Jun 15th, 2018 - about 6 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 | 1619931870 | NPPES |
| New Hampshire | MEDICAID | 3073841 | |
| New Hampshire | MEDICAID | 01929280 | |
| New Hampshire | Other | AA224057 | |
| New Hampshire | MEDICAID | 32000782 | |
| New Hampshire | Other | 002323701 | |
| New Hampshire | MEDICAID | 1019444 |
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