Individual
TIMOTHY F NOLAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 MAYES AVE, SPRINGFIELD, KY 40069-1415
(859) 336-3464
Mailing address
101 MAYES AVE, SPRINGFIELD, KY 40069-1415
(859) 336-3464
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
27153
KY
2084P0804X
Child & Adolescent Psychiatry Physician
27153
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000500349
ANTHEM
KY
05
—
30605018
—
KY
Enumeration date
12/09/2006
Last updated
02/06/2015
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