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General NPI Number Information
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NPI Number | 1750332995
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Entity Type | Individual
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Provider Name | TIMOTHY G CLOONAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 07/27/2016
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Provider Practice Location Address
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Address Line | 3050 N CIRCLE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-1175
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Country | US
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Telephone | 719-593-1799
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Fax | 719-265-3794
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Provider Business Mailing Address
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Address Line | 1390 KELLY JOHNSON BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-3908
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Country | US
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Telephone | 719-593-1799
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Fax | 719-265-3794
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 49946
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License Number State | CO
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