Simic, Timothy Robert

Simic, Timothy Robert is an sole proprietor health care provider with primary practice located at 1357 Bardstown Rd , Louisville KY 40204-1353. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Emergency, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Simic, Timothy Robert can be contacted via phone (502) 897-6443.

Contact Information

Primary practice address
1357 Bardstown Rd Louisville KY 40204-1353
Phone: (502) 897-6443
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Emergency 163WE0003X 1102450 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3015217 Kentucky

Profile Details

NPI number 1053904896
LBN Legal business name Simic, Timothy Robert
Credentials NURSE PRACTITIONER
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 12th, 2021
Last updated Mar 17th, 2022 - about 2 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 1053904896 NPPES
Kentucky MEDICAID 7100571750

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