Mullally, Timothy James

Mullally, Timothy James is an individual health care provider with primary practice located at 11275 Delaware Pkwy , Crown Point IN 46307-7812. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Mullally, Timothy James can be contacted via phone (219) 779-8735.

Contact Information

Primary practice address
11275 Delaware Pkwy Crown Point IN 46307-7812
Phone: (219) 779-8735
Fax: (877) 715-2312
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 02003099A Indiana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02003099A Indiana

Profile Details

NPI number 1366462046
LBN Legal business name Mullally, Timothy James
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Mar 25th, 2019 - about 7 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 1366462046 NPPES
Indiana MEDICAID 200829740

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