Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0402X | Child Neurologist | 41928 | AZ |
Y | 2084N0402X | Child Neurologist | MD469159 | PA |
NPI | 1114120953 |
---|---|
Provider Name | Dr. Jeremy Scott Timothy |
First Address | York, PA 17402-9001 |
Second Address | Manchester, PA 17345-1023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2007 |
Last Update Date | 20/12/2019 |