Doctor Name: | DR. DENNIS M TIMKO |
NPI Number: | 1013931815 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.M. |
License Number: | 2001014083 |
Business Practice Address: | 521 N Virginia Ave Eureka, MO - 630251115 |
Business Phone Number: | 8007070215 |
Business Fax Number: | 8007070215 |
Mailing Address: | 521 N Virginia Ave, EUREKA |
State: | MO |
Postal Code: | 630251115 |
Phone Number: | 8007070215 |
Fax Number: | 6369223535 |
NPI Enumeration Date: | 07/26/2006 |
NPI Last Update Date: | 04/22/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 2001014083 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |