Oltersdorf, Timothy P
Oltersdorf, Timothy P is an sole proprietor health care provider with primary practice located at 1101 6Th Ave , Fort Worth TX 76104-4377. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Oltersdorf, Timothy P can be contacted via phone (817) 336-4638.Contact Information
Primary practice address
1101 6Th Ave
Fort Worth TX 76104-4377
Phone: (817) 336-4638
Fax: (817) 870-0278
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | F8973 | Texas |
Profile Details
| NPI number | 1134128424 |
|---|---|
| LBN Legal business name | Oltersdorf, Timothy P |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 19th, 2005 |
| Last updated | Mar 31st, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134128424 | NPPES |
| Texas | MEDICAID | 124446902 |
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