NPI 1225196777 · live from the CMS NPI Registry
Timmie Joe Conrad, MD
Ophthalmology in Louisville, KY. National Provider Identifier 1225196777, active.
NPI record
| NPI | 1225196777 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Ophthalmology 207W00000X |
| Practice location | 204 Breckenridge Lane, Louisville, KY 40207 |
| Practice phone | 502-899-7778 |
| Mailing address | Po Box 6015, Louisville, KY 40206 |
| Enumerated | December 5, 2006 |
| Last updated | December 18, 2014 |
| Sole proprietor | Yes |
| Other names | Tim Conrad |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ophthalmology primary | 207W00000X | 29088 (KY) |
| Ophthalmology | 207W00000X | 01041184 (IN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.