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DAVID ALAN TIMM NPI 1710015318


NPI Information

NPI: 1710015318
Provider Name: DAVID ALAN TIMM

Doing Business As: PEDIATRIC & ADOLESCENT CLINIC

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 19D1005933

Address:
1806 CARTER ST
VIDALIA, LA
ZIP 71373
Phone: (318) 336-7172
Get Directions

DAVID ALAN TIMM is a pediatrics in Vidalia, LA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DAVID ALAN TIMM NPI is 1710015318. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Pediatric & Adolescent Clinic.

The provider's business location address is:

1806 CARTER ST
VIDALIA, LA
ZIP 71373-115
Phone: (318) 336-7172
Fax: (318) 336-7176

The provider's authorized official is David Alan Timm .
The authorized official title is Owner and has the following contact phone number (601) 442-7676.

The CLIA number assigned to this NPI record is 19D1005933 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/2/2007 and was last updated on 12/9/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsMD016299LOUISIANANo
2363LF0000XNurse PractitionerFamilyAPO4933LOUISIANANo
3363LF0000XNurse PractitionerFamilyAPO4870LOUISIANANo
4208000000XPediatrics016299LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11021829MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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