Healthcare Provider Details

I. General information

NPI: 1093232712
Provider Name (Legal Business Name): TIMOTHY DUANE LINDSEY BARBER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2017
Last Update Date: 08/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5915 SUEMANDY DR
SAINT PETERS MO
63376-4314
US

IV. Provider business mailing address

38 TWELVE OAKS CT
SAINT PETERS MO
63376-1891
US

V. Phone/Fax

Practice location:
  • Phone: 636-345-2990
  • Fax:
Mailing address:
  • Phone: 314-363-1002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: