Individual
TIMOTHY GLEN GAULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE ST., PHILADELPHIA, PA 19104-3309
(215) 349-8310
(215) 893-7270
Mailing address
3400 SPRUCE ST., PHILADELPHIA, PA 19104-3309
(215) 349-8310
(215) 893-7270
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
293047
MA
207L00000X
Anesthesiology Physician
MD457474
PA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
293047
MA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
MD457474
PA
Other
Enumeration date
06/24/2012
Last updated
08/11/2022
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