Timmerman, Mark G
Timmerman, Mark G is an individual health care provider with primary practice located at 436 Sunrise Dr , Spring Green WI 53588-9286. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Timmerman, Mark G can be contacted via phone (608) 588-2502.Contact Information
Primary practice address
436 Sunrise Dr
Spring Green WI 53588-9286
Phone: (608) 588-2502
Fax: (608) 588-7724
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 31402-020 | Wisconsin |
Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 31402-020 | Wisconsin |
Profile Details
NPI number | 1881649333 |
---|---|
LBN Legal business name | Timmerman, Mark G |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 23rd, 2006 |
Last updated | Apr 29th, 2008 - about 16 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 | 1881649333 | NPPES |
Wisconsin | MEDICAID | 31648300 | |
Wisconsin | Other | P00463755 |
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