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Organization
DAVID ALAN TIMM
Active
Organization
DAVID ALAN TIMM
Active
Other names
PEDIATRIC & ADOLESCENT CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE P RIFE (BUSINESS MGR)
(601) 442-7676
Entity
Organization
Contact information
Practice address
1806 CARTER STREET, VIDALIA, LA 71373-3115
(318) 336-7172
(318) 336-7172
Mailing address
308 HIGHLAND BLVD, NATCHEZ, MS 39120-4611
(601) 442-7676
(601) 442-9590
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
LA
Other
Enumeration date
02/21/2008
Last updated
12/18/2009
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