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NPI Code Detail

MEDICARE: DR. TIMOTHY M RODDY MD

MEDICARE: DR. TIMOTHY M RODDY 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
1208800000XUrology PhysicianMD00026286WA

General Provider Information

NPI Number : 1487696092
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY M RODDY MD
Provider Business Mailing Address
First Line : 21822 76TH AVE W
Second Line :
City : EDMONDS
State : WA
Zip : 98026-7900
Country : US
Telephone Number : 425-775-7166
Fax Number :
Provider Business Practice Location Address
First Line : 21822 76TH AVE W
Second Line :
City : EDMONDS
State : WA
Zip : 98026-7900
Country : US
Telephone Number : 425-775-7166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2006
Last Update Date : 11/16/2007

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Directions to “ DR. TIMOTHY M RODDY MD” Practice Location

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