MEDICARE: DR. TIMOTHY LYNN JOHNSTON DO

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
1	207Q00000X	Family Medicine Physician	2005-00369	NC

General Provider Information

NPI Number	:	1477521102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY LYNN JOHNSTON DO

Provider Business Mailing Address
First Line	:	315 WIKE CEMETERY RD
Second Line	:
City	:	CULLOWHEE
State	:	NC
Zip	:	28723-9550
Country	:	US
Telephone Number	:	828-293-0503
Fax Number	:	828-293-0107

Provider Business Practice Location Address
First Line	:	315 WIKE CEMETERY RD
Second Line	:
City	:	CULLOWHEE
State	:	NC
Zip	:	28723-9550
Country	:	US
Telephone Number	:	828-293-0503
Fax Number	:	828-293-0107

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	07/08/2007

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