Individual
TIMOTHY HOULIHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1405 MILL ST, NEW LONDON, WI 54961-2155
(920) 531-2400
(920) 531-2450
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3298
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30412
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31662300
—
WI
Enumeration date
07/20/2006
Last updated
07/08/2007
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