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General NPI Number Information
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NPI Number | 1760795801
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Entity Type | Organization
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Legal Business Name | TIMOTHY G MCNALLY DO PC
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 3364 S CENTER RD
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City | BURTON
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State | MI
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Zip | 48519-1458
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Country | US
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Telephone | 810-743-3937
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Fax | 810-743-9210
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Provider Business Mailing Address
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Address Line | 3364 S CENTER RD
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City | BURTON
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State | MI
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Zip | 48519-1458
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Country | US
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Telephone | 810-743-3937
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Fax | 810-743-9210
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Authorized Official
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Title or Position | BILLER
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Name | BRENDA K VOWELL
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Credential |
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Telephone | 989-666-6135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | TM012077
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License Number State | MI
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