Healthcare Provider Details

I. General information

NPI: 1629035407
Provider Name (Legal Business Name): TIMOTHY KEITH VEST M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 01/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1871 EVELYN BYRD AVE
HARRISONBURG VA
22801-3487
US

IV. Provider business mailing address

1871 EVELYN BYRD AVE
HARRISONBURG VA
22801-3487
US

V. Phone/Fax

Practice location:
  • Phone: 540-434-0559
  • Fax: 540-434-1348
Mailing address:
  • Phone: 540-434-0559
  • Fax: 540-434-1348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0101033977
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: