Smith, Tim Allen

Smith, Tim Allen is an individual health care provider with primary practice located at 2501 Keenan Dr , International Falls MN 56649-2181. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Smith, Tim Allen can be contacted via phone (218) 283-9431.

Contact Information

Primary practice address
2501 Keenan Dr International Falls MN 56649-2181
Phone: (218) 283-9431
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 53656 Minnesota
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 53656 Minnesota

Profile Details

NPI number 1881821619
LBN Legal business name Smith, Tim Allen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2009
Last updated Dec 5th, 2016 - about 8 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 1881821619 NPPES
Minnesota MEDICAID 1881821619
Minnesota MEDICAID 1881821619

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