Provider Demographics
NPI:1154663821
Name:TIMPANO, EDMUND JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:EDMUND
Middle Name:JOSEPH
Last Name:TIMPANO
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 1:1602 STARMONT TRL
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1827
Mailing Address - Country:US
Mailing Address - Phone:315-404-8882
Mailing Address - Fax:
Practice Address - Street 1:742 MIDDLE CREEK RD
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-5019
Practice Address - Country:US
Practice Address - Phone:865-466-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0082121207P00000X, 207PE0004X
TN64643207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services