Basic Information
| Provider Information | |||||||||
| NPI: | 1730587171 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TIMOTHY J PIRNAT MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5407 MEADOW VISTA WAY | ||||||||
| Address2: | |||||||||
| City: | AGOURA HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913011504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372186635 | ||||||||
| FaxNumber: | 8186712225 | ||||||||
| Practice Location | |||||||||
| Address1: | 950 PARK EAST BLVD | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 479050792 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372186635 | ||||||||
| FaxNumber: | 8186712225 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2014 | ||||||||
| LastUpdateDate: | 12/17/2014 | ||||||||
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| AuthorizedOfficialLastName: | PIRNAT | ||||||||
| AuthorizedOfficialFirstName: | TIMOTHY | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9372186635 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 35-05-9586 | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.