MEDICARE: DR. TIMOTHY J HELL OD

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	152W00000X	Optometrist	3181-035	WI

General Provider Information

NPI Number	:	1598078859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY J HELL OD

Provider Business Mailing Address
First Line	:	163 BETH CT
Second Line	:
City	:	BURLINGTON
State	:	WI
Zip	:	53105-1716
Country	:	US
Telephone Number	:	262-488-0146
Fax Number	:

Provider Business Practice Location Address
First Line	:	12876 W BLUEMOUND RD
Second Line	:
City	:	ELM GROVE
State	:	WI
Zip	:	53122-2605
Country	:	US
Telephone Number	:	262-432-0052
Fax Number	:

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

Provider Enumeration Date	:	07/15/2010
Last Update Date	:	11/15/2016

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