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:
Health care specialties
| Specialty | Code | License # | 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 17 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 | 1487743159 | NPPES |
| Connecticut | MEDICAID | 4041679 | |
| Connecticut | MEDICAID | 4024972 |
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