Individual
TIMOTHY WIDENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18701 N 67TH AVE, GLENDALE, AZ 85308-7100
(623) 561-7222
Mailing address
18701 N 67TH AVE, GLENDALE, AZ 85308-7100
(623) 561-7222
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
52601
AZ
Other
Enumeration date
05/01/2013
Last updated
01/08/2017
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