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NPI Code Detail

MEDICARE: DR. TIMOTHY A QUEEN M.D.

MEDICARE: DR. TIMOTHY A QUEEN M.D.
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
1207K00000XAllergy & Immunology Physician0101051871VA
2207Y00000XOtolaryngology Physician0101051871VA
3207YX0602XOtolaryngic Allergy Physician0101051871VA

General Provider Information

NPI Number : 1164422507
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY A QUEEN M.D.
Provider Business Mailing Address
First Line : 11842 ROCK LANDING DR.
Second Line : SUITE 100
City : NEWPORT NEWS
State : VA
Zip : 23606
Country : US
Telephone Number : 757-873-0338
Fax Number : 757-873-9579
Provider Business Practice Location Address
First Line : 11842 ROCK LANDING DR STE 100
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23606-4437
Country : US
Telephone Number : 757-873-0338
Fax Number : 757-873-9579
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 03/19/2025

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