Individual
TIMOTHY P NEWCOMB
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3400 DEXTER CT, SUITE 101, DAVENPORT, IA 52807-3461
(563) 344-6600
(563) 344-6699
Mailing address
3400 DEXTER CT, SUITE 101, DAVENPORT, IA 52807-3461
(563) 344-6600
(563) 344-6699
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
D-094792
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0435800
—
IA
01
—
16166
BLUECROSS BLUE SHIELD
IA
01
—
IA0120
JOHN DEERE HEALTHPLAN
IA
01
—
P00232878
RAILROAD MEDICARE
IA
Enumeration date
04/26/2006
Last updated
07/08/2007
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