Provider Demographics
NPI:1083200786
Name:BAYSINGER, TIMOTHY (PHARMD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:BAYSINGER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32800 SCHLAPPI RD
Mailing Address - Street 2:
Mailing Address - City:DEER CREEK
Mailing Address - State:IL
Mailing Address - Zip Code:61733-9414
Mailing Address - Country:US
Mailing Address - Phone:309-397-6187
Mailing Address - Fax:
Practice Address - Street 1:155 E COURTLAND ST
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:IL
Practice Address - Zip Code:61550-8931
Practice Address - Country:US
Practice Address - Phone:309-263-6728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051303629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist