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NPI Code Detail

MEDICARE: ALAN L. TIMS M.D.

MEDICARE:   ALAN L. TIMS  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208C00000XColon & Rectal Surgery Physician26883MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11423031OTHERMEDICA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
340022TIOTHERMNBCBSM

General Provider Information

NPI Number : 1871561720
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALAN L. TIMS M.D.
Provider Business Mailing Address
First Line : 8170 33RD AVE S
Second Line : MS21110Q
City : MINNEAPOLIS
State : MN
Zip : 55425-4516
Country : US
Telephone Number : 952-883-5375
Fax Number : 320-203-2113
Provider Business Practice Location Address
First Line : 2251 CONNECTICUT AVENUE S
Second Line : HP CENTRAL MN CLINICS
City : SARTELL
State : MN
Zip : 56377-2486
Country : US
Telephone Number : 320-253-5220
Fax Number : 320-203-2113
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2006
Last Update Date : 06/15/2012

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