Yazzie, Timothy
Yazzie, Timothy is an individual health care provider with primary practice located at 1134 N 500 W Suite 102, Provo UT 84604-3383. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Yazzie, Timothy can be contacted via phone (801) 357-1770.Contact Information
Primary practice address
1134 N 500 W Suite 102
Provo UT 84604-3383
Phone: (801) 357-1770
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 18-2006 | New Mexico |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 331777-1204 | Utah |
Profile Details
| NPI number | 1639218662 |
|---|---|
| LBN Legal business name | Yazzie, Timothy |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 6th, 2007 |
| Last updated | Jun 27th, 2022 - about 2 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 | 1639218662 | NPPES |
| Colorado | MEDICAID | 33732361 | |
| Colorado | MEDICAID | 04452755 | |
| Colorado | MEDICAID | 253562 |
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