Doctor Name: | TIMOTHY J SIEGFRIED |
NPI Number: | 1164536256 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | 200 |
Business Practice Address: | 10229 E 96th St N Suite 100 Owasso, OK - 740555305 |
Business Phone Number: | 9182728920 |
Business Fax Number: | 9182728922 |
Mailing Address: | 5711 E 71st St, Suite 220 TULSA |
State: | OK |
Postal Code: | 741366628 |
Phone Number: | 9184777096 |
Fax Number: | 9184779362 |
NPI Enumeration Date: | 08/18/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |