Provider Demographics
NPI:1154320265
Name:GOSLEE, TIMOTHY E (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:E
Last Name:GOSLEE
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 1:14 BRAMBLEBUSH PARK
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2325
Mailing Address - Country:US
Mailing Address - Phone:508-540-0511
Mailing Address - Fax:508-540-5186
Practice Address - Street 1:14 BRAMBLEBUSH PARK
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2325
Practice Address - Country:US
Practice Address - Phone:508-540-0511
Practice Address - Fax:508-540-5186
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA36509207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0801139OtherUNITED HEALTHCARE
MAJ20048OtherBC/BS
MA2286084OtherCIGNA
MA15013OtherPILGRIM HEALTH
MA538276OtherUS HEALTHCARE
MA036509OtherTUFTS
MA2050064Medicaid
MA000000030597OtherBMC HEALTHNET
MA0554720001Medicare NSC
MAA59404Medicare UPIN
MA0801139OtherUNITED HEALTHCARE