Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 13209 | NV |
N | 208600000X | Surgeon | 13209 | NV |
Y | 2086S0105X | Surgery of the Hand | 13209 | NV |
NPI | 1982711628 |
---|---|
Provider Name | Timothy W Tollestrup |
First Address | Henderson, NV 89052-4189 |
Second Address | Henderson, NV 89052-4189 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 11/03/2010 |