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General NPI Number Information
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NPI Number | 1457764680
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Entity Type | Individual
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Provider Name | TIMOTHY JAMES AINGER M.S., M.A., PHD
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Gender | Male
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Dates
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Enumeration Date | 06/05/2014
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 740 S LIMESTONE J401
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City | LEXINGTON
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State | KY
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Zip | 40511
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Country | US
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Telephone | 859-323-5661
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Fax |
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Provider Business Mailing Address
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Address Line | 740 S LIMESTONE KY CLINIC J401
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City | LEXINGTON
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State | KY
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Zip | 40536-0001
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Country | US
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Telephone | 859-323-5661
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Fax |
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 239811
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License Number State | KY
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