Provider Demographics
NPI:1053331256
Name:BILL, TIMOTHY J (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:J
Last Name:BILL
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 1:2058 PRO POINTE LN
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801
Mailing Address - Country:US
Mailing Address - Phone:540-438-0600
Mailing Address - Fax:
Practice Address - Street 1:2058 PRO POINTE LN
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801
Practice Address - Country:US
Practice Address - Phone:540-438-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056247174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9364868OtherCIGNA PROV #
VA289223OtherANTHEM PROV #
VA224564OtherCOVENTRY PROV #
VAC08749Medicare ID - Type UnspecifiedMEDICARE GRP #
H90468Medicare UPIN
VA224564OtherCOVENTRY PROV #
VA9364868OtherCIGNA PROV #