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General NPI Number Information
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NPI Number | 1861570004
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Entity Type | Individual
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Provider Name | TIMOTHY C PHILPOTT MD
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Gender | Male
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 3023 N BALLAS RD STE 120D
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2330
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Country | US
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Telephone | 314-432-3669
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Fax | 314-432-3118
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Provider Business Mailing Address
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Address Line | PO BOX 7412065
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City | CHICAGO
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State | IL
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Zip | 60674-2065
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Country | US
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Telephone | 314-432-3669
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Fax | 314-432-3118
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 106250
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License Number State | MO
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