Individual
TIMOTHY JAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 E 1ST ST, MORRIS, MN 56267-1408
(320) 287-3162
Mailing address
400 E 1ST ST, MORRIS, MN 56267-1408
(320) 589-1313
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
66621
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57.026603
OHIO TRAINING LICENCE
OH
Enumeration date
04/07/2015
Last updated
10/15/2021
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