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NPI Code Detail

MEDICARE: MR. TIMOTHY JAMES HORNYAK PA-C

MEDICARE: MR. TIMOTHY JAMES HORNYAK PA-C
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
1363AS0400XSurgical Physician AssistantMA053826PA

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 : 1851384473
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TIMOTHY JAMES HORNYAK PA-C
Provider Business Mailing Address
First Line : 2389 HENPECK LN
Second Line :
City : FRANKLIN
State : TN
Zip : 37064-5208
Country : US
Telephone Number : 615-807-1497
Fax Number :
Provider Business Practice Location Address
First Line : 1310 24TH AVE S
Second Line :
City : NASHVILLE
State : TN
Zip : 37212-2637
Country : US
Telephone Number : 615-873-7620
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 10/16/2012

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