Individual
TIMOTHY JAMES EGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
800 ROSE ST, ROOM M53, LEXINGTON, KY 40536-0298
(859) 323-5908
(859) 323-8056
Mailing address
800 ROSE ST RM M53, LEXINGTON, KY 40536-0298
(859) 323-5908
(859) 323-8056
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2546
KY
363AM0700X
Medical Physician Assistant
PA2546
KY
363AS0400X
Surgical Physician Assistant
PA2546
KY
Other
Enumeration date
06/19/2019
Last updated
08/17/2020
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