Basic Information
| Provider Information | |||||||||
| NPI: | 1366447450 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WORKMAN | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | O | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 457 | ||||||||
| Address2: | 200 POCAHONTAS TRAIL | ||||||||
| City: | WHITE SULPHUR SPRINGS | ||||||||
| State: | WV | ||||||||
| PostalCode: | 249860457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3045365030 | ||||||||
| FaxNumber: | 3045365031 | ||||||||
| Practice Location | |||||||||
| Address1: | 296 FAIR ST. | ||||||||
| Address2: | TIMOTHY O. WORKMAN, MD | ||||||||
| City: | LEWISBURG | ||||||||
| State: | WV | ||||||||
| PostalCode: | 249012632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046474747 | ||||||||
| FaxNumber: | 3046474293 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2005 | ||||||||
| LastUpdateDate: | 05/24/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 1202 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 541839718 | 01 | C&O | OTHER | 200026 | 01 | LUNG | OTHER | 236403117 | 01 | TRICARE | OTHER | 5181993 | 01 | CCN | OTHER | 58246 | 01 | CARELINK | OTHER | 5916968 | 01 | CIGNA | OTHER | 58246 | 01 | SOUTHERN HEALTH | OTHER | 541839718011 | 01 | WV | BS MOUNTAIN STATE | OTHER | 0042092000 | 05 | WV | MEDICAID | 005630797 | 05 | VA | MEDICAID | 245039 | 01 | WV | ANTHEM | OTHER | 4539949 | 01 | AETNA | OTHER | 454181 | 01 | VA | ANTHEM | OTHER |