Healthcare Provider Details

I. General information

NPI: 1033101878
Provider Name (Legal Business Name): TIMOTHY C KUO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 HOSPITAL RD STE A
WINCHESTER TN
37398-2495
US

IV. Provider business mailing address

155 HOSPITAL RD STE A
WINCHESTER TN
37398-2495
US

V. Phone/Fax

Practice location:
  • Phone: 931-962-0374
  • Fax: 901-902-5510
Mailing address:
  • Phone: 931-962-0374
  • Fax: 901-902-5510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number74954
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: