Provider Demographics
NPI:1083642755
Name:MATTHEWS, TIMOTHY H (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:H
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1169 EASTERN PKWY
Mailing Address - Street 2:SUITE G 71
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217-1417
Mailing Address - Country:US
Mailing Address - Phone:502-456-6217
Mailing Address - Fax:502-456-4440
Practice Address - Street 1:4000 KRESGE WAY
Practice Address - Street 2:PATHOLOGY DEPT
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4605
Practice Address - Country:US
Practice Address - Phone:502-897-8226
Practice Address - Fax:502-897-8215
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2011-09-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY23574207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL124519600OtherWORKERS COMP FLORIDA
OH31155000400OtherWORKERS COMP OHIO
KY64235740Medicaid
KY220030398OtherRAILROAD MEDICARE
KY11-00181OtherUNITED HEALTHCARE
KY000000190614OtherANTHEM BL CROSS BL SHIELD
KY1139492OtherMEDICAID PASSPORT
IN200031030AOtherMEDICAID INDIANA
KY104509OtherHEALTH PARTNERS
KY2438018000OtherPASSPORT ADVANTAGE
KY2561713OtherCIGNA HEALTHCARE
KY1139492OtherMEDICAID PASSPORT
KYF08613Medicare UPIN