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Individual

MR. TIMOTHY NEIL COWTHORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3240 AVALON BLVD, CONYERS, GA 30013-6320
(770) 860-1133
(770) 860-1599
Mailing address
3240 AVALON BLVD, CONYERS, GA 30013-6320
(770) 860-1133
(770) 860-1599

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
051031
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
389285461A
GA
Enumeration date
03/20/2006
Last updated
02/09/2012
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