Provider Demographics
NPI:1558572164
Name:MILNER, TIMOTHY PATTERSON (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:PATTERSON
Last Name:MILNER
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 1:5700 HILLANDALE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-4120
Mailing Address - Country:US
Mailing Address - Phone:678-580-1149
Mailing Address - Fax:770-557-1347
Practice Address - Street 1:5700 HILLANDALE DRIVE STE. 150
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058
Practice Address - Country:US
Practice Address - Phone:678-580-1149
Practice Address - Fax:770-557-1347
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000399102086S0129X
GA059622086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty