Individual
MR. TIMOTHY JAY DARE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
505 EISENHOWER DR, SAVANNAH, GA 31406-2668
(912) 354-6190
Mailing address
505 EISENHOWER DR, SAVANNAH, GA 31406-2668
(912) 354-6190
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003559
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003559
STATE LICENSE
GA
01
—
10448572
NCCPA
GA
05
—
360301582A
—
GA
Enumeration date
02/08/2006
Last updated
03/07/2023
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