MEDICARE: DR. TIMOTHY SCOTT MOUSER 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
1	207W00000X	Ophthalmology Physician	2004-01281	NC

General Provider Information

NPI Number	:	1720075336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY SCOTT MOUSER M.D.

Provider Business Mailing Address
First Line	:	106 FARM BROOK DR STE B
Second Line	:
City	:	LUMBERTON
State	:	NC
Zip	:	28358-2178
Country	:	US
Telephone Number	:	910-738-4856
Fax Number	:	910-738-7999

Provider Business Practice Location Address
First Line	:	106 FARM BROOK DR STE B
Second Line	:
City	:	LUMBERTON
State	:	NC
Zip	:	28358-2178
Country	:	US
Telephone Number	:	910-738-4856
Fax Number	:	910-738-7999

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

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	06/04/2026

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