Healthcare Provider Details

I. General information

NPI: 1831129287
Provider Name (Legal Business Name): TIM ROBERT VALKO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 04/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 EXECUTIVE PARKWAY 8TH FL
TOLEDO OH
43606-1309
US

IV. Provider business mailing address

3130 EXECUTIVE PARKWAY 8TH FL
TOLEDO OH
43606-1309
US

V. Phone/Fax

Practice location:
  • Phone: 419-720-9000
  • Fax: 419-720-9002
Mailing address:
  • Phone: 419-720-9000
  • Fax: 419-720-9002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35058758
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: