Individual
TIMOTHY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 442-0711
(860) 444-3733
Mailing address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 442-0711
(860) 444-3733
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
025823
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4024972
—
CT
05
—
4041679
—
CT
Enumeration date
10/12/2006
Last updated
07/09/2007
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