Basic Information
| Provider Information | |||||||||
| NPI: | 1508867664 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TIMBERT | ||||||||
| FirstName: | DAVIS | ||||||||
| MiddleName: | SCOTT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1240 EAGLES LANDING PKWY | ||||||||
| Address2: | SUITE 280 | ||||||||
| City: | STOCKBRIDGE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302815170 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7705075055 | ||||||||
| FaxNumber: | 7705075880 | ||||||||
| Practice Location | |||||||||
| Address1: | 1240 EAGLES LANDING PKWY | ||||||||
| Address2: | SUITE 280 | ||||||||
| City: | STOCKBRIDGE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302815170 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7705075055 | ||||||||
| FaxNumber: | 7705075880 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2005 | ||||||||
| LastUpdateDate: | 01/02/2017 | ||||||||
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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 | 208600000X | GA037404 | GA | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.