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General NPI Number Information
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NPI Number | 1215061452
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Entity Type | Organization
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Legal Business Name | B. TIMOTHY SCHAEFFER MD PC
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 12/05/2007
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Provider Practice Location Address
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Address Line | 214 HOSPITAL CIR
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City | BLAIRSVILLE
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State | GA
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Zip | 30512-3102
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Country | US
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Telephone | 706-894-1546
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Fax | 706-894-1548
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Provider Business Mailing Address
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Address Line | PO BOX 756
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City | BALDWIN
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State | GA
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Zip | 30511-0756
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Country | US
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Telephone | 706-894-1546
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Fax | 706-894-1548
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Authorized Official
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Title or Position | PRESIDENT
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Name | BERTON TIMOTHY SCHAEFFER
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Credential | MD
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Telephone | 706-894-1546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 010278
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License Number State | GA
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