Kerut, Timothy P

Kerut, Timothy P is an individual health care provider with primary practice located at 2200 Highway 61 N , Vicksburg MS 39183-8246. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Kerut, Timothy P can be contacted via phone (601) 883-3320.

Contact Information

Primary practice address
2200 Highway 61 N Vicksburg MS 39183-8246
Phone: (601) 883-3320
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 11047 Mississippi

Profile Details

NPI number 1932130127
LBN Legal business name Kerut, Timothy P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Sep 10th, 2020 - about 6 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 1932130127 NPPES
Mississippi MEDICAID 00120441
Mississippi Other 5694020
Mississippi MEDICAID 1546143

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