Provider Demographics
NPI:1780726299
Name:GORSKI, TIMOTHY N (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:N
Last Name:GORSKI
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 1:7259 S BINGHAM JUNCTION BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-4860
Mailing Address - Country:US
Mailing Address - Phone:800-453-3030
Mailing Address - Fax:
Practice Address - Street 1:1001 N WALDROP DR
Practice Address - Street 2:SUITE 815
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4705
Practice Address - Country:US
Practice Address - Phone:817-792-2000
Practice Address - Fax:817-277-3720
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD29075207V00000X
WI101522207V00000X
MN77808207V00000X
TXH3059207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH3059OtherSTATE MEDICAL LICENSE #
WI1780726299Medicaid
TXB23080Medicare UPIN