MEDICARE: TIMOTHY KINNEY MD

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	207RG0100X	Gastroenterology Physician	101841	MN

General Provider Information

NPI Number	:	1407895139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY KINNEY MD

Provider Business Mailing Address
First Line	:	500 HARVARD ST SE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55455-0363
Country	:	US
Telephone Number	:	612-273-3000
Fax Number	:	612-273-4370

Provider Business Practice Location Address
First Line	:	500 HARVARD ST SE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55455-0363
Country	:	US
Telephone Number	:	612-273-3000
Fax Number	:	612-273-4370

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	03/08/2018

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