Individual
DR. TIMOTHY WALTER TESLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1275 SADLER WAY, SUITE 102, FAIRBANKS, AK 99701-3175
(907) 457-7874
(907) 457-7060
Mailing address
1275 SADLER WAY, SUITE 102, FAIRBANKS, AK 99701-3175
(907) 457-7874
(907) 457-7060
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
3579
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD17701
—
AK
Enumeration date
03/08/2007
Last updated
06/05/2008
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