Provider Demographics
NPI:1407805401
Name:LOUIE, TIMOTHY JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JAY
Last Name:LOUIE
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 1:645 N ARLINGTON AVE
Mailing Address - Street 2:STE 655
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4444
Mailing Address - Country:US
Mailing Address - Phone:775-770-6465
Mailing Address - Fax:775-770-3554
Practice Address - Street 1:645 N ARLINGTON AVE STE 655
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4444
Practice Address - Country:US
Practice Address - Phone:775-770-6465
Practice Address - Fax:770-775-3554
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV82922084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002016195Medicaid
NV002016195Medicaid
NVG59537Medicare UPIN
NV130018471Medicare PIN