1427147065 NPI number — TIMOTHY P HALLINAN MD

Table of content: TIMOTHY P HALLINAN MD (NPI 1427147065)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427147065 NPI number — TIMOTHY P HALLINAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HALLINAN
Provider First Name:
TIMOTHY
Provider Middle Name:
P
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427147065
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
709 W 8TH STREET
Provider Second Line Business Mailing Address:
SUITE 4
Provider Business Mailing Address City Name:
GILLETTE
Provider Business Mailing Address State Name:
WY
Provider Business Mailing Address Postal Code:
82716-4125
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
307-682-3333
Provider Business Mailing Address Fax Number:
307-682-6723

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
709 W 8TH ST
Provider Second Line Business Practice Location Address:
FAMILY MEDICAL CARE
Provider Business Practice Location Address City Name:
GILLETTE
Provider Business Practice Location Address State Name:
WY
Provider Business Practice Location Address Postal Code:
82716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
307-682-3333
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/12/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  3332A , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)