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General NPI Number Information
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NPI Number | 1770754137
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Entity Type | Individual
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Provider Name | TIMOTHY JAMES LEROY MD
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Gender | Male
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Dates
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Enumeration Date | 03/13/2008
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 9245 PARK WEST BLVD
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City | KNOXVILLE
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State | TN
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Zip | 37923-4425
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Country | US
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Telephone | 865-690-3811
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Fax | 865-525-6498
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Provider Business Mailing Address
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Address Line | 10200 GRAND CENTRAL AVE STE 220
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City | OWINGS MILLS
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State | MD
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Zip | 21117-4366
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Country | US
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Telephone |
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Fax |
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | ME99488
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | MD0000047250
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License Number State | TN
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