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NPI Code Detail

MEDICARE: TIMBROOK PHYSICIAN SERVICES, LLC

MEDICARE: TIMBROOK PHYSICIAN SERVICES, LLC
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
1207R00000XInternal Medicine Physician
2363A00000XPhysician Assistant
3363L00000XNurse Practitioner
4208000000XPediatrics Physician

General Provider Information

NPI Number : 1417890914
Entity Type Code : Organization
Provider Name (Legal Business Name) : TIMBROOK PHYSICIAN SERVICES, LLC
Provider Business Mailing Address
First Line : 200 CORPORATE BLVD
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-3870
Country : US
Telephone Number : 800-893-9698
Fax Number :
Provider Business Practice Location Address
First Line : 1840 AMHERST ST
Second Line :
City : WINCHESTER
State : VA
Zip : 22601-2808
Country : US
Telephone Number : 540-536-8000
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT
Name : LISHA FALK
Credential :
Telephone Number : 337-609-1221
Provider Enumeration Date : 04/10/2026
Last Update Date : 04/10/2026

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Directions to “TIMBROOK PHYSICIAN SERVICES, LLC ” Practice Location

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