Individual
TIMOTHY LEE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1009 N STATE OF FRANKLIN ACCESS RD, JOHNSON CITY, TN 37604-3693
(423) 929-7546
(423) 929-7968
Mailing address
1009 N STATE OF FRANKLIN ACCESS RD, JOHNSON CITY, TN 37604-3693
(423) 929-7546
(423) 929-7968
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
38003
TN
207ND0900X
Dermatopathology Physician
38003
TN
207NS0135X
Procedural Dermatology Physician
38003
TN
Other
Enumeration date
10/25/2005
Last updated
06/01/2009
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