Provider Demographics
NPI:1558483800
Name:JANIGA, TIMOTHY A (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:A
Last Name:JANIGA
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 1:500 DAMONTE RANCH PKWY #703
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521
Mailing Address - Country:US
Mailing Address - Phone:775-398-4600
Mailing Address - Fax:775-398-4606
Practice Address - Street 1:500 DAMONTE RANCH PKWY #703
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521
Practice Address - Country:US
Practice Address - Phone:775-398-4600
Practice Address - Fax:775-398-4606
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12651208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHJA4213951Medicare PIN