MEDICARE: DR. TIMOTHY LEE SIZEMORE PHARMD

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	183500000X	Pharmacist	03-125939	OH

General Provider Information

NPI Number	:	1245239722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY LEE SIZEMORE PHARMD

Provider Business Mailing Address
First Line	:	222 W MAPLE AVE
Second Line	:
City	:	OAK HILL
State	:	OH
Zip	:	45656-1060
Country	:	US
Telephone Number	:	740-682-6994
Fax Number	:

Provider Business Practice Location Address
First Line	:	90 JACKSON PIKE
Second Line	:
City	:	GALLIPOLIS
State	:	OH
Zip	:	45631-1560
Country	:	US
Telephone Number	:	740-446-5236
Fax Number	:	740-446-5846

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	07/08/2007

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