MEDICARE: DR. TIMOTHY WILLIAM HALENKAMP M.D. MPH

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	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	339460-1205	UT

General Provider Information

NPI Number	:	1275534950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY WILLIAM HALENKAMP M.D. MPH

Provider Business Mailing Address
First Line	:	10651 E ST
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78419-5130
Country	:	US
Telephone Number	:	361-961-6163
Fax Number	:	361-961-2829

Provider Business Practice Location Address
First Line	:	10651 E ST
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78419-5130
Country	:	US
Telephone Number	:	361-961-6166
Fax Number	:	361-961-2829

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	07/08/2007

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