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Individual

DR. TIMOTHY T MIMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2443 SIR BARTON WAY STE 275, LEXINGTON, KY 40509
(812) 962-7890
(812) 476-6162
Mailing address
7145 E VIRGINIA ST STE 2000, EVANSVILLE, IN 47715-9147
(812) 962-7890
(812) 476-6162

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
231723
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
48908
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02566392
NY
05
7100428760
KY
Enumeration date
01/03/2006
Last updated
08/10/2018
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