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Individual
DR. TIMOTHY LOGAN GARDNER
Active
Individual
DR. TIMOTHY LOGAN GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DPM 409
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000053556
BCBS
KY
01
—
0191729
BCBS
TN
05
—
3351921
—
TN
05
—
80002017
—
KY
Enumeration date
05/10/2006
Last updated
04/26/2022
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