Organization
TIMOTHY KINGSBURY D O INC
Active
Other names
Timothy Kingsbury D O P C
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY KINGSBURY D.O. (OWNER)
(207) 439-9924
Entity
Organization
Contact information
Practice address
111 ROGERS RD, KITTERY, ME 03904-1453
(207) 439-9924
(207) 439-5992
Mailing address
PO BOX 189, KITTERY, ME 03904-0189
(207) 439-9924
(207) 439-5992
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
1254
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720172844
NPI
—
05
—
1D119310000
—
ME
01
—
MM1151
MEDICARE PTAN
—
Enumeration date
12/14/2010
Last updated
04/26/2011
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