Individual
TIMOTHY JEIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10785 W TWAIN AVE STE 219, LAS VEGAS, NV 89135-3028
(702) 350-2906
Mailing address
1701 W CHARLESTON BLVD, STE 160, LAS VEGAS, NV 89102-2325
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
16431
NV
2084P0800X
Psychiatry Physician
MD.207143
LA
2084P0800X
Psychiatry Physician
PGY.202293
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16431
NSBME
NV
01
—
MD.207143
LSBME
LA
01
—
PGY.202293
INTERNSHIP/RESIDENCY - TRAINING PURPOSES ONLY
LA
Enumeration date
04/05/2013
Last updated
03/17/2022
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