MEDICARE: TIMOTHY E HARMON PA

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	363AM0700X	Medical Physician Assistant

General Provider Information

NPI Number	:	1053640177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY E HARMON PA

Provider Business Mailing Address
First Line	:	NAVY BRANCH HEALTH CLINIC IWAKUNI JAPAN
Second Line	:	PSC 561 BOX 1877
City	:	IWAKUNI
State	:	JAPAN
Zip	:	96310
Country	:	JP
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	NAVY BRANCH HEALTH CLINIC IWAKUNI JAPAN
Second Line	:	PSC 561 BOX 1877
City	:	IWAKUNI
State	:	JAPAN
Zip	:	96310
Country	:	JP
Telephone Number	:	810-243-3445
Fax Number	:

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

Provider Enumeration Date	:	12/19/2009
Last Update Date	:	12/19/2009

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