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Contact Information

TIMOTHY L GENDRON, MD
149 THOMPSON AVE E STE 150
WEST SAINT PAUL, MN55118-3238
 Phone: 651-450-0860
 Fax: 651-450-0759
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for TIMOTHY L GENDRON · (Male)

NPI Number 1316968985
Status Active
Credentials MD
Entity Individual
Enumeration date 07/21/2006
Last updated 06/27/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • CA License # C173229
  • MA License # 205100
  • MN License # 56058
  • RI License # MD10047
  • WI License # 69137-20
Hospital affiliation(s) Not Available
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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