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:
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Health care specialties

SpecialtyCodeLicense #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 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508836057 NPPES
Pennsylvania MEDICAID 1279561

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