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NPI Code Detail

MEDICARE: DR. TIMOTHY LEE SCHOONOVER D.O.

MEDICARE: DR. TIMOTHY LEE SCHOONOVER D.O.
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
12084N0400XNeurology Physician34-00-6467-SOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11033111802OTHEROHCHAMPUS/TRICARE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033111802
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY LEE SCHOONOVER D.O.
Provider Business Mailing Address
First Line : 1975 MIAMISBURG CENTERVILLE RD
Second Line :
City : CENTERVILLE
State : OH
Zip : 45459-3811
Country : US
Telephone Number : 937-439-6186
Fax Number : 937-439-9900
Provider Business Practice Location Address
First Line : 1975 MIAMISBURG CENTERVILLE RD
Second Line :
City : CENTERVILLE
State : OH
Zip : 45459-3811
Country : US
Telephone Number : 937-439-6186
Fax Number : 937-439-9900
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 07/03/2024

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