Provider Demographics
NPI:1730676834
Name:GAUNTNER, TIMOTHY DANIEL (DO, PHD)
Entity type:Individual
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First Name:TIMOTHY
Middle Name:DANIEL
Last Name:GAUNTNER
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Gender:M
Credentials:DO, PHD
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Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-6196
Mailing Address - Fax:614-366-0073
Practice Address - Street 1:2121 KENNY RD FL 5
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-3100
Practice Address - Country:US
Practice Address - Phone:614-293-6196
Practice Address - Fax:614-366-0073
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34.017322207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology