Provider Demographics
NPI:1366447450
Name:WORKMAN, TIMOTHY O (DO)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:O
Last Name:WORKMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:200 POCAHONTAS TRAIL
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:24986-0457
Mailing Address - Country:US
Mailing Address - Phone:304-536-5030
Mailing Address - Fax:304-536-5031
Practice Address - Street 1:296 FAIR ST.
Practice Address - Street 2:TIMOTHY O. WORKMAN, MD
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-2632
Practice Address - Country:US
Practice Address - Phone:304-647-4747
Practice Address - Fax:304-647-4293
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA1202207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
541839718OtherC&O
200026OtherLUNG
236403117OtherTRICARE
5181993OtherCCN
58246OtherCARELINK
5916968OtherCIGNA
58246OtherSOUTHERN HEALTH
WV541839718011OtherBS MOUNTAIN STATE
WV0042092000Medicaid
VA005630797Medicaid
WV245039OtherANTHEM
4539949OtherAETNA
VA454181OtherANTHEM
200026OtherLUNG
5916968OtherCIGNA
WV245039OtherANTHEM
1519679Medicare ID - Type UnspecifiedUMWA
WV0644952Medicare PIN