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:
Health care specialties
Specialty | Code | License # | 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 3 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 | 1053904896 | NPPES |
Kentucky | MEDICAID | 7100571750 |
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