MEDICARE: TIMOTHY F COYNE 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	3171	AZ

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	:	1285607978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY F COYNE PA-C

Provider Business Mailing Address
First Line	:	5620 W THUNDERBIRD RD STE B3
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85306-4638
Country	:	US
Telephone Number	:	602-206-6262
Fax Number	:	602-235-0274

Provider Business Practice Location Address
First Line	:	5620 W THUNDERBIRD RD STE B3
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85306-4638
Country	:	US
Telephone Number	:	602-206-6262
Fax Number	:	602-235-0296

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

Provider Enumeration Date	:	02/11/2006
Last Update Date	:	01/12/2026

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Directions to “ TIMOTHY F COYNE PA-C” Practice Location

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