Healthcare Provider Details

I. General information

NPI: 1891743498
Provider Name (Legal Business Name): JOHN W. TIMMONS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 12/15/2022
Certification Date: 12/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13737 SPOTSWOOD TRL
ELKTON VA
22827-3200
US

IV. Provider business mailing address

220 CAMPUS BLVD STE 100
WINCHESTER VA
22601-2888
US

V. Phone/Fax

Practice location:
  • Phone: 540-298-1200
  • Fax: 540-298-1144
Mailing address:
  • Phone: 540-536-5100
  • Fax: 540-536-0235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101043469
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: