MEDICARE: TIMOTHY E QUINN MD

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	207Q00000X	Family Medicine Physician	MD049790L	PA
2	207Q00000X	Family Medicine Physician	ME165502	FL

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	:	1659390235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY E QUINN MD

Provider Business Mailing Address
First Line	:	1611 OREGON PIKE
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17601-4335
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 CYPRESS EDGE DR STE 209
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-8454
Country	:	US
Telephone Number	:	386-586-1790
Fax Number	:	386-586-1791

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	09/26/2024

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Directions to “ TIMOTHY E QUINN MD” Practice Location

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