Healthcare Provider Details

I. General information

NPI: 1083625461
Provider Name (Legal Business Name): TIMOTHY S WINKLER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1711 CHURCH ST STE B
NORFOLK VA
23504-2303
US

IV. Provider business mailing address

501 DISCOVERY DR
CHESAPEAKE VA
23320-3843
US

V. Phone/Fax

Practice location:
  • Phone: 757-938-3654
  • Fax: 757-938-3658
Mailing address:
  • Phone: 757-547-5145
  • Fax: 757-312-0216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0110001960
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0110001960
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: