Healthcare Provider Details

I. General information

NPI: 1013908466
Provider Name (Legal Business Name): TIMOTHY ANDREW PRESNELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 03/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CLINIC DR CLAYPOOL HILL
RICHLANDS VA
24641-1102
US

IV. Provider business mailing address

PO BOX CVPI
RICHLANDS VA
24641-1100
US

V. Phone/Fax

Practice location:
  • Phone: 276-964-6771
  • Fax: 276-964-1319
Mailing address:
  • Phone: 276-964-6771
  • Fax: 276-964-1319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101036584
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: