Provider Demographics
NPI:1033101878
Name:KUO, TIMOTHY C (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:C
Last Name:KUO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-2414
Mailing Address - Country:US
Mailing Address - Phone:402-721-2623
Mailing Address - Fax:402-721-2339
Practice Address - Street 1:1550 E 23RD ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2414
Practice Address - Country:US
Practice Address - Phone:402-721-2623
Practice Address - Fax:402-721-2339
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE22720207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025098000Medicaid
NE10025098000Medicaid
NE277642Medicare ID - Type Unspecified