Provider Demographics
NPI:1013357102
Name:KUO, TIM (DO)
Entity Type:Individual
Prefix:
First Name:TIM
Middle Name:
Last Name:KUO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 SAINT ROSE PKWY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3839
Mailing Address - Country:US
Mailing Address - Phone:702-616-6102
Mailing Address - Fax:
Practice Address - Street 1:3001 SAINT ROSE PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3839
Practice Address - Country:US
Practice Address - Phone:702-616-6102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO2201207P00000X
CA20A17032207P00000X
MI5101020513207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine