MEDICARE: TIMOTHY WEEKS PA-C

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
1	363A00000X	Physician Assistant	50.007691RX	OH

General Provider Information

NPI Number	:	1043948771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY WEEKS PA-C

Provider Business Mailing Address
First Line	:	200 BRIAR AVE NE
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-2621
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1130 S MAIN ST
Second Line	:
City	:	ENGLEWOOD
State	:	OH
Zip	:	45322-2819
Country	:	US
Telephone Number	:	937-208-6879
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2022
Last Update Date	:	12/05/2025

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