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General NPI Number Information
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NPI Number | 1750439212
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Entity Type | Organization
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Legal Business Name | J. TIMOTHY GARNER, MD, PLLC
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 03/26/2014
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Provider Practice Location Address
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Address Line | 1205 MONTGOMERY AVE STE 4
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City | ASHLAND
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State | KY
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Zip | 41101-3518
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Country | US
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Telephone | 606-324-0340
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Fax | 606-324-0044
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Provider Business Mailing Address
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Address Line | 1205 MONTGOMERY AVE STE 4
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City | ASHLAND
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State | KY
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Zip | 41101-2669
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Country | US
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Telephone | 606-324-0340
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Fax | 606-324-0044
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Authorized Official
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Title or Position | OWNER
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Name | JOHN TIMOTHY GARNER
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Credential | MD
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Telephone | 606-324-0340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3008408
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 33507
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License Number State | KY
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