Smith, Timothy

Smith, Timothy is an individual health care provider with primary practice located at 365 Montauk Ave , New London CT 06320-4700. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Smith, Timothy can be contacted via phone (860) 442-0711.

Contact Information

Primary practice address
365 Montauk Ave New London CT 06320-4700
Phone: (860) 442-0711
Fax: (860) 444-3733
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 025823 Connecticut

Profile Details

NPI number 1487743159
LBN Legal business name Smith, Timothy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2006
Last updated Jul 9th, 2007 - about 18 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 1487743159 NPPES
Connecticut MEDICAID 4041679
Connecticut MEDICAID 4024972

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