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General NPI Number Information
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NPI Number | 1730587171
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Entity Type | Organization
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Legal Business Name | TIMOTHY J PIRNAT MD INC
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Dates
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Enumeration Date | 12/17/2014
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Last Update Date | 12/17/2014
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Provider Practice Location Address
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Address Line | 950 PARK EAST BLVD
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City | LAFAYETTE
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State | IN
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Zip | 47905-0792
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Country | US
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Telephone | 937-218-6635
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Fax | 818-671-2225
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Provider Business Mailing Address
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Address Line | 5407 MEADOW VISTA WAY
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City | AGOURA HILLS
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State | CA
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Zip | 91301-1504
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Country | US
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Telephone | 937-218-6635
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Fax | 818-671-2225
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Authorized Official
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Title or Position | PRESIDENT
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Name | TIMOTHY J PIRNAT
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Credential | M.D.
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Telephone | 937-218-6635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 35-05-9586
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License Number State | OH
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