Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 2007007213 | MO |
NPI | 1255368759 |
---|---|
Provider Name | Timothy James Billharz |
First Address | Liberty, MO 64068-2388 |
Second Address | Liberty, MO 64068-9607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 29/07/2019 |