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NPI Code Detail

MEDICARE: TIMOTHY PLANK DO

MEDICARE: TIMOTHY PLANK DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician34004783OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003802141
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY PLANK DO
Provider Business Mailing Address
First Line : 420 SUPERIOR ST
Second Line :
City : SANDUSKY
State : OH
Zip : 44870-1849
Country : US
Telephone Number : 419-626-5623
Fax Number : 419-626-8778
Provider Business Practice Location Address
First Line : 420 SUPERIOR ST
Second Line :
City : SANDUSKY
State : OH
Zip : 44870-1849
Country : US
Telephone Number : 419-626-5623
Fax Number : 419-626-8778
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2005
Last Update Date : 02/18/2025

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Directions to “ TIMOTHY PLANK DO” Practice Location

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