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General NPI Number Information
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NPI Number | 1376501734
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Entity Type | Individual
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Provider Name | TIMOTHY JON STORER MD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 12 LEXINGTON BLVD
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City | DELAWARE
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State | OH
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Zip | 43015-4071
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Country | US
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Telephone | 740-362-0794
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Fax | 740-368-4118
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Provider Business Mailing Address
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Address Line | PO BOX 7527
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City | DUBLIN
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State | OH
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Zip | 43017-0727
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Country | US
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Telephone | 740-362-0794
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Fax | 740-368-4118
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 350791535
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License Number State | OH
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