Provider Demographics
NPI:1164433090
Name:VISSCHER, TIMOTHY STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:STEVEN
Last Name:VISSCHER
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 1:234 E REEDER ST
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:MT
Mailing Address - Zip Code:59725-2783
Mailing Address - Country:US
Mailing Address - Phone:406-532-8400
Mailing Address - Fax:406-543-9316
Practice Address - Street 1:234 E REEDER ST
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:MT
Practice Address - Zip Code:59725-2783
Practice Address - Country:US
Practice Address - Phone:406-532-8400
Practice Address - Fax:406-543-9316
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT51452084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000081639Medicare ID - Type Unspecified
MTC64214Medicare UPIN