Individual
TIMOTHY STEPHEN MCCOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 852-5851
(502) 852-3762
Mailing address
205 W BOUTZ RD, BLDG 1, LAS CRUCES, NM 88005-3262
(575) 532-7000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2001-252
NM
207L00000X
Anesthesiology Physician
Primary
53040
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300042816
—
IN
05
—
7100679560
—
KY
05
—
E2168
—
NM
Enumeration date
02/24/2006
Last updated
10/15/2020
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