Individual
TIMOTHY ARTHUR ROUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
9521 SAN MATEO BLVD NE, ALBUQUERQUE, NM 87113-2237
(505) 923-5941
Mailing address
4472 BATTLEVIEW PL, SMYRNA, GA 30082-4480
(770) 375-0998
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/26/2023
Last updated
05/26/2023
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