Smith, Timothy Craig
Smith, Timothy Craig is an individual health care provider with primary practice located at 4641 Roosevelt Blvd , Philadelphia PA 19124-2343. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Smith, Timothy Craig can be contacted via phone (215) 831-7853.Contact Information
Primary practice address
4641 Roosevelt Blvd
Philadelphia PA 19124-2343
Phone: (215) 831-7853
Fax: (215) 831-7910
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | MD044874L | Pennsylvania |
Profile Details
| NPI number | 1508836057 |
|---|---|
| LBN Legal business name | Smith, Timothy Craig |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2006 |
| Last updated | Jul 8th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508836057 | NPPES |
| Pennsylvania | MEDICAID | 1279561 |
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