Provider Demographics
NPI:1821180555
Name:MINGES, TIMOTHY J (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:J
Last Name:MINGES
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 1:208 N 1ST ST
Mailing Address - Street 2:P O BOX 286
Mailing Address - City:WESTMORELAND
Mailing Address - State:KS
Mailing Address - Zip Code:66549
Mailing Address - Country:US
Mailing Address - Phone:785-457-3311
Mailing Address - Fax:785-457-3431
Practice Address - Street 1:711 GENN DRIVE
Practice Address - Street 2:
Practice Address - City:WAMEGO
Practice Address - State:KS
Practice Address - Zip Code:66547
Practice Address - Country:US
Practice Address - Phone:785-456-2995
Practice Address - Fax:785-456-6916
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0418907207Q00000X
KS04-18907208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100144670AMedicaid
KS100144670AMedicaid
KS003465Medicare ID - Type Unspecified