Scanlon, Timothy Shawn

Scanlon, Timothy Shawn is an individual health care provider with primary practice located at 3535 Southern Blvd , Kettering OH 45429-1221. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Scanlon, Timothy Shawn can be contacted via phone (937) 395-8166.

Contact Information

Primary practice address
3535 Southern Blvd Kettering OH 45429-1221
Phone: (937) 395-8166
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 2540 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 50.001117 Ohio

Profile Details

NPI number 1730147919
LBN Legal business name Scanlon, Timothy Shawn
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated May 6th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730147919 NPPES
Ohio MEDICAID 0078665

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