Provider Demographics
NPI:1245233386
Name:HONKALA, TIMOTHY K (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:K
Last Name:HONKALA
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 1:1200 BROOKS LN
Mailing Address - Street 2:STE G20
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3752
Mailing Address - Country:US
Mailing Address - Phone:412-267-5040
Mailing Address - Fax:412-384-3505
Practice Address - Street 1:1200 BROOKS LN
Practice Address - Street 2:STE G20
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3752
Practice Address - Country:US
Practice Address - Phone:412-267-5040
Practice Address - Fax:412-384-3505
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044326L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01706357Medicaid
PA01396998Medicaid
PA0548900003Medicare NSC
PA200008974Medicare ID - Type UnspecifiedRAILROAD
PA0584900001Medicare ID - Type Unspecified
PAHO665470Medicare ID - Type UnspecifiedINDIVIDUAL
PA01706357Medicaid
PA01396998Medicaid