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Individual
TIMOTHY A HUMPHRIES
Active
Individual
TIMOTHY A HUMPHRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
053461
GA
2086S0127X
Trauma Surgery Physician
Primary
53641
GA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
53641
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
715822455
—
GA
Enumeration date
05/12/2006
Last updated
05/26/2021
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