Healthcare Provider Details

I. General information

NPI: 1497169940
Provider Name (Legal Business Name): TIMOTHY MUSICK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2014
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 W MOANA LN STE 300
RENO NV
89509-4980
US

IV. Provider business mailing address

745 W MOANA LN STE 300
RENO NV
89509-4980
US

V. Phone/Fax

Practice location:
  • Phone: 775-784-6063
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number16959
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: