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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

TIMOTHY P CONNELLY JR, MD
1101 LEXINGTON AVE
SAVANNAH, GA31404-5502
 Phone: 912-350-7171
 Fax: 912-350-3454
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for TIMOTHY P CONNELLY JR · (Male)

NPI Number 1467616748
Credentials MD
Entity Individual
Enumeration date 07/15/2008
Last updated 09/27/2012 - About 4 years ago
Sole proprietor 1 No
Identifiers
GA License # 067895
GA Medicaid 288192878C
SC Medicaid GA1309
GA Medicare PIN 202I117561
GA Other P01059478 RAILROAD MEDICARE
Hospital affiliation(s)
  • COASTAL CAROLINA HOSPITAL - (Acute Care)
    1000 MEDICAL CENTER DRIVE
    HARDEEVILLE, SC 29927
  • MEMORIAL HEALTH UNIV MED CEN INC - (Acute Care)
    4700 WATERS AVENUE
    SAVANNAH, GA 31403
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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