Individual
DR. TIMOTHY ALAN MIKESELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 N 1ST ST, SPRINGFIELD, IL 62702-3757
(217) 757-2387
(217) 788-5582
Mailing address
701 N 1ST ST, BOX 101, SPRINGFIELD, IL 62781-0001
(217) 757-2387
(217) 788-5582
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
125.062755
IL
Other
Enumeration date
06/17/2013
Last updated
06/17/2013
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