Individual
TIMOTHY R EDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 THEDA CLARK MEDICAL PLZ, NEENAH, WI 54956-2721
(920) 720-6440
(920) 993-5093
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(920) 830-5900
(920) 830-5910
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
036078276
IL
207RG0100X
Gastroenterology Physician
Primary
37531
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32235600
—
WI
Enumeration date
07/09/2006
Last updated
03/23/2026
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