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General NPI Number Information
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NPI Number | 1922001437
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Entity Type | Individual
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Provider Name | TIMOTHY J HEYD M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/30/2005
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Last Update Date | 11/19/2015
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Provider Practice Location Address
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Address Line | 416 S EAST ST
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City | LEBANON
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State | OH
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Zip | 45036-2378
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Country | US
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Telephone | 513-695-1228
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Fax | 513-695-2941
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Provider Business Mailing Address
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Address Line | 9549 MONTGOMERY RD 100
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City | CINCINNATI
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State | OH
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Zip | 45242-7238
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Country | US
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Telephone | 513-489-3737
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Fax | 513-984-3796
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34063863H
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License Number State | OH
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