Humphries, Timothy A

Humphries, Timothy A is an sole proprietor health care provider with primary practice located at 100 Doctors Dr Ste C , Douglas GA 31533-2211. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), Allopathic & Osteopathic Physicians / Trauma Surgery. Allopathic & Osteopathic Physicians / Trauma Surgery is his primary health care specialty. Humphries, Timothy A can be contacted via phone (912) 384-5832.

Contact Information

Primary practice address
100 Doctors Dr Ste C Douglas GA 31533-2211
Phone: (912) 384-5832
Fax: (912) 383-8279
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 053461 Georgia
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 53641 Georgia
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X 53641 Georgia

Profile Details

NPI number 1689625162
LBN Legal business name Humphries, Timothy A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 12th, 2006
Last updated May 26th, 2021 - 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 1689625162 NPPES
Georgia MEDICAID 715822455

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