Individual
DR. TIMOTHY DENNIS CASSIDY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2200 BERGQUIST DR, ATTN: CREDENTIALS (CMS), LACKLAND A F B, TX 78236-9907
(210) 292-6707
(210) 292-7964
Mailing address
2200 BERGQUIST DR, ATTN: CREDENTIALS (CMS), LACKLAND A F B, TX 78236-9908
(210) 292-6707
(210) 292-7964
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4404
AK
Other
Enumeration date
02/13/2006
Last updated
07/08/2007
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