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General NPI Number Information
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NPI Number | 1285847699
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Entity Type | Individual
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Provider Name | TIMOTHY YEE-TAK KO MD
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Gender | Male
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 2374 VILLAGE COMMON DR STE 100
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City | ERIE
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State | PA
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Zip | 16506-7201
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Country | US
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Telephone | 814-833-7246
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Fax | 814-833-1147
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Provider Business Mailing Address
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Address Line | 2374 VILLAGE COMMON DR STE 100
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City | ERIE
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State | PA
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Zip | 16506-7201
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Country | US
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Telephone | 814-833-7246
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Fax | 814-833-1147
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | MD462767
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 35.087753
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License Number State | OH
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