Individual
DR. TIMOTHY JAMES MONAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2016 S MAIN ST, MARYVILLE, MO 64468-2655
(660) 563-2525
Mailing address
2016 S MAIN ST, MARYVILLE, MO 64468-2655
(816) 271-7196
(816) 271-6786
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
04-37130
KS
207X00000X
Orthopaedic Surgery Physician
2004021600
MO
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
04-37130
KS
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
2004021600
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200688130B
—
KS
Enumeration date
10/05/2005
Last updated
11/16/2021
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