Provider Demographics
NPI:1346328762
Name:STRATTON, TIMOTHY PATRICK (PHD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:PATRICK
Last Name:STRATTON
Suffix:
Gender:M
Credentials:PHD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5619 LONDON RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55804-2516
Mailing Address - Country:US
Mailing Address - Phone:218-525-5811
Mailing Address - Fax:
Practice Address - Street 1:386A KIRBY PLAZA
Practice Address - Street 2:1208 KIRBY DRIVE
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55812
Practice Address - Country:US
Practice Address - Phone:218-726-6018
Practice Address - Fax:218-726-6500
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118200-81835P1200X
AK8061835P1200X
CA372661835P1200X
AZ72671835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy