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NPI Code Detail

MEDICARE: THOMAS R TIMKO M.D.

MEDICARE: THOMAS R TIMKO M.D.
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
1207R00000XInternal Medicine Physician35-056964OH

Other Identifiers

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

General Provider Information

NPI Number : 1467456319
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS R TIMKO M.D.
Provider Business Mailing Address
First Line : 9471 MARKET ST
Second Line : SUITE B
City : NORTH LIMA
State : OH
Zip : 44452-8702
Country : US
Telephone Number : 330-729-2388
Fax Number : 330-629-6468
Provider Business Practice Location Address
First Line : 107 ROYAL BIRKDALE DR STE A
Second Line :
City : COLUMBIANA
State : OH
Zip : 44408-8493
Country : US
Telephone Number : 330-482-9350
Fax Number : 330-482-2336
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 08/16/2018

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