Individual
TIMOTHY K KINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4242 FARNAM ST, #355, OMAHA, NE 68131-2806
(402) 552-2222
(402) 552-9710
Mailing address
4242 FARNAM ST, #355, OMAHA, NE 68131-2806
(402) 552-2222
(402) 552-9710
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
15299
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47055826613
—
NE
01
—
98653
BCBSIA
IA
Enumeration date
07/04/2006
Last updated
07/08/2007
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