| Organization Name: | TIMOTHY KINGSBURY D O INC |
| NPI Number: | 1962705905 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TIMOTHY KINGSBURY (OWNER) |
| Mailing Address: | 111 Rogers Rd Kittery |
| State: | ME US |
| Postal Code: | 039041453 |
| Phone Number: | 2074399924 |
| Fax Number: | 2074395992 |
| NPI Enumeration Date: | 12/14/2010 |
| NPI Last Update Date: | 04/26/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 1254 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |