Provider Demographics
NPI:1902868813
Name:GARNER, TIMOTHY FRANCIS (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:FRANCIS
Last Name:GARNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-6395
Mailing Address - Country:US
Mailing Address - Phone:740-387-3256
Mailing Address - Fax:740-383-4906
Practice Address - Street 1:241 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-6395
Practice Address - Country:US
Practice Address - Phone:740-387-3256
Practice Address - Fax:740-383-4906
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-051305207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0695805Medicaid
A17414Medicare UPIN
OH0615226Medicare PIN