Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 8588 | KY |
N | 204E00000X | Oral & Maxillofacial Surgeon | 8588 | KY |
NPI | 1194850875 |
---|---|
Provider Name | Dr. Timothy Scott Acord |
First Address | Louisville, KY 40222-3455 |
Second Address | Louisville, KY 40222-3455 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 29/06/2015 |