NPI Code Detail JSON Logo

1487986725 NPI number — TIMOTHY EBBITT M.D.

NPI Number: 1487986725
Health Care Provider/Practitioner: TIMOTHY EBBITT M.D.

Information about “1487986725” NPI (TIMOTHY EBBITT M.D.) exists in 1487986725 in HTML format HTML  |  1487986725 in plain Text format TXT  |  1487986725 in PDF (Portable Document Format) PDF  |  1487986725 in an XML format XML  formats.

NPI Number : 1487986725 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1487986725",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "EBBITT",
    "FirstName": "TIMOTHY",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6500 EXCELSIOR BLVD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ST LOUIS PARK",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "55426-4702",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "952-993-1000",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6500 EXCELSIOR BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ST LOUIS PARK",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "55426",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "952-993-1000",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/11/2010",
    "LastUpdateDate": "07/19/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2085R0202X",
        "TaxonomyName": "Diagnostic Radiology Physician",
        "LicenseNumber": "58928",
        "LicenseNumberStateCode": "MN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.