Individual
TIMOTHY W TEDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
777 HEMLOCK ST, MACON, GA 31201-2102
(866) 507-5244
(855) 851-4405
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(855) 851-4405
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1131140
KY
163W00000X
Registered Nurse
28213083A
IN
163W00000X
Registered Nurse
317661
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
RN244914
GA
Other
Enumeration date
01/07/2015
Last updated
02/27/2015
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