Taylor, Timothy Osborn

Taylor, Timothy Osborn is an sole proprietor health care provider with primary practice located at 2330 Coronado St , Idaho Falls ID 83404-7407. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Taylor, Timothy Osborn can be contacted via phone (208) 552-1234.

Contact Information

Primary practice address
2330 Coronado St Idaho Falls ID 83404-7407
Phone: (208) 552-1234
Fax: (208) 522-9580
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X M5782 Idaho

Profile Details

NPI number 1033121322
LBN Legal business name Taylor, Timothy Osborn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 13th, 2006
Last updated Jan 15th, 2012 - about 13 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 1033121322 NPPES
Idaho Other DI379 BLUE CROSS
Idaho Other 000012701 BLUE CROSS
Idaho MEDICAID 804289600 BLUE CROSS
Idaho Other 0004082 BLUE CROSS

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