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Individual
TIMOTHY JAY
Active
Individual
TIMOTHY JAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
66621
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57.026603
OHIO TRAINING LICENCE
OH
Enumeration date
04/07/2015
Last updated
10/15/2021
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