MEDICARE: TIMOTHY ANDERSON SR.

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1639003767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY ANDERSON SR.

Provider Business Mailing Address
First Line	:	5577 AIRPORT HWY STE 200
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-7364
Country	:	US
Telephone Number	:	419-720-0442
Fax Number	:	419-754-2085

Provider Business Practice Location Address
First Line	:	5577 AIRPORT HWY STE 200
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-7364
Country	:	US
Telephone Number	:	419-720-0442
Fax Number	:	419-754-2085

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

Provider Enumeration Date	:	06/12/2026
Last Update Date	:	06/12/2026

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Directions to “ TIMOTHY ANDERSON SR. ” Practice Location

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