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General NPI Number Information
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NPI Number | 1811550601
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Entity Type | Organization
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Legal Business Name | J. TIMOTHY AMES, MD PC
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 04/17/2019
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Provider Practice Location Address
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Address Line | 751 E PORTER AVE STE 5
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City | CHESTERTON
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State | IN
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Zip | 46304-9111
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Country | US
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Telephone | 219-767-4858
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Fax | 219-413-9682
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Provider Business Mailing Address
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Address Line | 751 E PORTER AVE STE 5
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City | CHESTERTON
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State | IN
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Zip | 46304-9111
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Country | US
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Telephone | 219-767-4858
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Fax | 219-413-9682
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAY TIMOTHY AMES
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Credential | MD
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Telephone | 219-767-4858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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