Individual
MR. TIMOTHY JAMES MOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
114 GAUSE, SLIDELL, LA 70460
(985) 643-6262
Mailing address
5800 KENSINGTON BLVD, NEW ORLEANS, LA 70127-2809
(504) 722-9234
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
15027
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4895267
—
LA
Enumeration date
03/30/2011
Last updated
03/30/2011
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