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General NPI Number Information
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NPI Number | 1629065149
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Entity Type | Individual
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Provider Name | TIMOTHY W. EARLEY O.D.
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Gender | Male
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Dates
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Enumeration Date | 09/30/2005
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 888 MEMORIAL DR STE 201
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City | OAKLAND
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State | MD
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Zip | 21550-5112
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Country | US
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Telephone | 301-334-1146
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Fax | 301-334-9729
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Provider Business Mailing Address
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Address Line | 888 MEMORIAL DR
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City | OAKLAND
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State | MD
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Zip | 21550-5112
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Country | US
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Telephone | 301-334-1146
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Fax | 301-334-9729
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4924/T1794
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 4924/T1794
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | 4924/T1794
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 4924/T1794
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA2997
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License Number State | MD
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