Timothy D Amidon, DO
Individual provider Active NPI Emergency Medical Services (Emergency Medicine) Physician · Sandusky, OH
NPI 1972597912 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1972597912
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician 207PE0004X
- License
- 34008829A (OH)
- Practice address
- 1101 Decatur St
Sandusky, OH 44870-3335 - Phone
- (419) 626-7400
- NPI assigned
- Sep 6, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34008829A | OH | MD | Emergency Medical Services (Emergency Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Medicine Physicians of Guernsey County, LTD | Past | Accepting new patients | |
| Marion Physician Billing LLC | Past | Accepting new patients | |
| Marion General Hospital Foundation, Inc. | Past | Accepting new patients | |
| Marysville Emergency Physicians Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 34008829A | OH | Yes |
Addresses
Primary practice location
1101 Decatur St
Sandusky, OH 44870-3335
Mailing address
2203 Eagles Nest Cir
Sandusky, OH 44870-7024
Phone (419) 625-1343
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2480837 | Medicaid | OH |
Other providers in Sandusky, OH
- Michelle Lynn Alten
- Amazing Angels LLC
- Amedisys Ohio, L.L.C.
- America'S Best Contacts & Eyeglasses
- American Homepatient, Inc.
- Connor James Anderson
- Kelly Sue Anderson
- Timothy Charles Andres
- Jacqueline Andrzejewski
- Rene Anese
All providers in Sandusky, OH · Emergency Medical Services (Emergency Medicine) Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.