Provider Demographics
NPI:1033760236
Name:NORMAN, TIMOTHY J (PA-C)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:J
Last Name:NORMAN
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 1:2384 N MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-1637
Mailing Address - Country:US
Mailing Address - Phone:440-319-8905
Mailing Address - Fax:
Practice Address - Street 1:2384 N MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-1637
Practice Address - Country:US
Practice Address - Phone:740-689-4935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-28
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant