Provider Demographics
NPI:1730771528
Name:TRELOAR, TIMOTHY C (PA-C)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:C
Last Name:TRELOAR
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11407, DEPT #8094
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-8094
Mailing Address - Country:US
Mailing Address - Phone:251-340-7900
Mailing Address - Fax:
Practice Address - Street 1:3715 DAUPHIN ST STE 7A
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1775
Practice Address - Country:US
Practice Address - Phone:251-340-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
AL1997363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant