Dutton, Timothy R.

Dutton, Timothy R. is an individual health care provider with primary practice located at 800 N Fant St , Anderson SC 29621-5708. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Dutton, Timothy R. can be contacted via phone (864) 512-1787.

Contact Information

Primary practice address
800 N Fant St Anderson SC 29621-5708
Phone: (864) 512-1787
Fax: (864) 222-8575
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X A759 South Carolina

Profile Details

NPI number 1801853569
LBN Legal business name Dutton, Timothy R.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2006
Last updated May 30th, 2012 - about 14 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 1801853569 NPPES
Georgia MEDICAID 393510150A
Georgia MEDICAID QM0668

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