NPI 1164499513
Timothy Macon, SFIDC
Practice location
- Address
- 123 Sully St, Goose Creek, SC 29445-5447
- Phone
- (843) 797-0003
Registered specialties
Independent Duty Corpsman
Primary
Registry record
- NPI
- 1164499513
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 3 Mar 2006
- Record last updated
- 8 Jul 2007
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.