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NPI Code Detail

MEDICARE: DR. TIMOTHY GENE HIESTERMAN DO

MEDICARE: DR. TIMOTHY GENE HIESTERMAN DO
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
1207XX0801XOrthopaedic Trauma PhysicianDO223864OR

General Provider Information

NPI Number : 1508044421
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY GENE HIESTERMAN DO
Provider Business Mailing Address
First Line : 2780 E BARNETT RD STE 200
Second Line :
City : MEDFORD
State : OR
Zip : 97504-8674
Country : US
Telephone Number : 541-779-6250
Fax Number : 541-608-2470
Provider Business Practice Location Address
First Line : 2780 E BARNETT RD STE 200
Second Line :
City : MEDFORD
State : OR
Zip : 97504-8674
Country : US
Telephone Number : 541-779-6250
Fax Number : 541-608-2470
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2008
Last Update Date : 03/17/2026

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