Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 072876 | GA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 251241 | NY |
NPI | 1205086931 |
---|---|
Provider Name | Dr. Timothy John Minton |
First Address | Savannah, GA 31405 |
Second Address | Savannah, GA 31405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2008 |
Last Update Date | 04/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003152522A | (05) | GA |