Individual
TIMOTHY S SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Mailing address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Taxonomy
Speciality
Code
Description
License number
State
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
036093943
IL
2086S0129X
Vascular Surgery Physician
Primary
036093943
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036093943
—
IL
Enumeration date
02/10/2006
Last updated
04/04/2019
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