Individual
ALVIN MICHAEL TIMOTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1320 MARTIN LUTHER KING DR, THIBODAUX, LA 70301-4886
(985) 446-2021
(985) 447-1546
Mailing address
PO BOX 4176, HOUMA, LA 70361-4176
(985) 872-5864
(985) 872-0317
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
203140
LA
207RI0011X
Interventional Cardiology Physician
Primary
203140
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1800252
—
LA
Enumeration date
10/31/2006
Last updated
10/19/2015
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