Provider Demographics
NPI:1467626945
Name:FRANTZ, TIMOTHY DREW (MD)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:DREW
Last Name:FRANTZ
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 1:2450 SISTER MARY COLUMBA DR
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-4356
Mailing Address - Country:US
Mailing Address - Phone:530-527-0414
Mailing Address - Fax:
Practice Address - Street 1:2450 SISTER MARY COLUMBA DR
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-4356
Practice Address - Country:US
Practice Address - Phone:530-528-1220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOOG699670207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G699670OtherMEDI CAL
CA00G699670OtherMEDI CAL
CAOOG699670Medicare PIN