Provider Demographics
NPI:1891003240
Name:EKPO, TIMOTHY EPHRIAM (DO)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:EPHRIAM
Last Name:EKPO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12303 PINEHURST LN
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-2634
Mailing Address - Country:US
Mailing Address - Phone:814-323-3942
Mailing Address - Fax:
Practice Address - Street 1:12303 PINEHURST LN
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-2634
Practice Address - Country:US
Practice Address - Phone:814-323-3942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017150207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery