Olthoff, Timothy D

Olthoff, Timothy D is an individual health care provider with primary practice located at 810 Whipple St , Prescott AZ 86301-1606. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Olthoff, Timothy D can be contacted via phone (928) 771-7577.

Contact Information

Primary practice address
810 Whipple St Prescott AZ 86301-1606
Phone: (928) 771-7577
Fax: (928) 458-2080
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 02002900 Indiana
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 006190 Arizona

Profile Details

NPI number 1225019425
LBN Legal business name Olthoff, Timothy D
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2005
Last updated Jul 21st, 2022 - about 3 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 1225019425 NPPES
Indiana Other P00324999 RR MEDICARE
Indiana MEDICAID 200521590 RR MEDICARE

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