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General NPI Number Information
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NPI Number | 1174608020
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Entity Type | Organization
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Legal Business Name | DAVID ALAN TIMM
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 308 HIGHLAND BLVD
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City | NATCHEZ
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State | MS
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Zip | 39120-4611
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Country | US
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Telephone | 601-442-7676
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Fax | 601-442-9590
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Provider Business Mailing Address
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Address Line | 308 HIGHLAND BLVD
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City | NATCHEZ
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State | MS
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Zip | 39120-4611
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Country | US
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Telephone | 601-442-7676
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Fax | 601-442-9590
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID ALAN TIMM
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Credential | M. D.
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Telephone | 601-442-7676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C5115
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 10207
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 016299
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R691941
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN066376 APO4870
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License Number State | LA
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R863841
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License Number State | MS
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN109495 APO04933
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License Number State | LA
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Taxonomy #8
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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