MEDICARE: TIMOTHY M. TOLAN, M.D., INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician

General Provider Information

NPI Number	:	1134348816
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIMOTHY M. TOLAN, M.D., INC.

Provider Business Mailing Address
First Line	:	5785 S. FORT APACHE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148
Country	:	US
Telephone Number	:	702-735-1400
Fax Number	:

Provider Business Practice Location Address
First Line	:	5785 S. FORT APACHE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148
Country	:	US
Telephone Number	:	702-735-1400
Fax Number	:	702-688-4193

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. TIMOTHY M TOLAN
Credential	:	M.D.
Telephone Number	:	702-735-1400

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	08/22/2020

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