Basic Information
| Provider Information | |||||||||
| NPI: | 1265475669 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MYNES | ||||||||
| FirstName: | TIMOTHY | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 GREEN RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481051598 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349953764 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8770 OHIO RIVER RD | ||||||||
| Address2: | |||||||||
| City: | WHEELERSBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 456941918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403565000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2006 | ||||||||
| LastUpdateDate: | 06/03/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PE0004X | 34008071 | OH | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services |
No ID Information.