Sanborn, Timothy A.

Sanborn, Timothy A. is an individual health care provider with primary practice located at 6308 8Th Ave , Kenosha WI 53143. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Sanborn, Timothy A. can be contacted via phone (262) 653-3650.

Contact Information

Primary practice address
6308 8Th Ave Kenosha WI 53143
Phone: (262) 653-3650
Fax: (262) 656-3672
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 036102493 Illinois
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 69326 Wisconsin

Profile Details

NPI number 1073600987
LBN Legal business name Sanborn, Timothy A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2006
Last updated Jul 25th, 2018 - about 8 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 1073600987 NPPES
Wisconsin MEDICAID 1073600987

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