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NPI Code Detail

MEDICARE: MR. TIMOTHY WILLIAM ABBOTT PA-C

MEDICARE:  MR. TIMOTHY WILLIAM ABBOTT  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2363A00000XPhysician Assistant

General Provider Information

NPI Number : 1023152212
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TIMOTHY WILLIAM ABBOTT PA-C
Provider Business Mailing Address
First Line : 1677 S GARFIELD ST
Second Line :
City : DENVER
State : CO
Zip : 80210-3005
Country : US
Telephone Number : 303-715-9176
Fax Number :
Provider Business Practice Location Address
First Line : 1677 S GARFIELD ST
Second Line :
City : DENVER
State : CO
Zip : 80210-3005
Country : US
Telephone Number : 303-715-9176
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2007
Last Update Date : 10/20/2009

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Directions to “ MR. TIMOTHY WILLIAM ABBOTT PA-C” Practice Location

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