| Timothy Kingsbury D O P C | |
|
111 Rogers Rd Kittery ME 03904-1453 | |
| (207) 439-9924 | |
| (207) 439-5992 |
| Full Name | Timothy Kingsbury D O P C |
|---|---|
| Speciality | General Practice |
| Location | 111 Rogers Rd, Kittery, Maine |
| Authorized Official Name and Position | Timothy Kingsbury (OWNER) |
| Authorized Official Contact | 2074399924 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Timothy Kingsbury D O P C Po Box 189 Kittery ME 03904-0189 Ph: (207) 439-9924 | Timothy Kingsbury D O P C 111 Rogers Rd Kittery ME 03904-1453 Ph: (207) 439-9924 |
| NPI Number | 1962705905 |
|---|---|
| Provider Enumeration Date | 12/14/2010 |
| Last Update Date | 04/26/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962705905 | NPI | - | NPPES |
| 1D119310000 | Medicaid | ME | |
| 1720172844 | Other | NPI | |
| MM1151 | Other | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 1254 (Maine) | Primary |
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