Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 278 | AR |
Y | 222Z00000X | Podiatrist | 278 | AR |
N | 213EP1101X | Primary Podiatric Medicine | 278 | AR |
N | 2081S0010X | Sports Medicine | 278 | AR |
N | 213ES0000X | Sports Medicine | 278 | AR |
N | 213ES0103X | Foot & Ankle Surgery | 278 | AR |
NPI | 1346651494 |
---|---|
Provider Name | Dr. Timothy Wayne Gauldin |
First Address | Hot Springs, AR 71901-7157 |
Second Address | Hot Springs, AR 71901-7157 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2014 |
Last Update Date | 23/04/2019 |