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Individual
DR. TIMOTHY LEE LONGACRE
Active
Individual
DR. TIMOTHY LEE LONGACRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17200
NE
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
17200
NE
208D00000X
General Practice Physician
17200
NE
Other
Enumeration date
12/15/2006
Last updated
03/18/2013
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