Provider Demographics
NPI:1285184531
Name:TIMOTHY HURLBURT
Entity Type:Organization
Organization Name:TIMOTHY HURLBURT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HIGBIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-746-8977
Mailing Address - Street 1:30 ALDRIN RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4804
Mailing Address - Country:US
Mailing Address - Phone:508-746-8977
Mailing Address - Fax:508-747-9680
Practice Address - Street 1:30 ALDRIN RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4804
Practice Address - Country:US
Practice Address - Phone:508-746-8977
Practice Address - Fax:508-747-9680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA5716363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty