MEDICARE: TIMOTHY FRANCIS TIMMONS 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
1	207R00000X	Internal Medicine Physician	215148	NY
2	208000000X	Pediatrics Physician	215148	NY
3	207R00000X	Internal Medicine Physician	R9450	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1053468249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY FRANCIS TIMMONS D.O.

Provider Business Mailing Address
First Line	:	PO BOX 34703
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98124-1703
Country	:	US
Telephone Number	:	206-764-3335
Fax Number	:	206-764-0489

Provider Business Practice Location Address
First Line	:	2053 WESTERN VILLAGE LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77043-2704
Country	:	US
Telephone Number	:	917-412-0808
Fax Number	:

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

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	09/12/2023

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