Provider Demographics
NPI:1487647947
Name:TIMKO, ANTHONY LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:LOUIS
Last Name:TIMKO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7300 RANCH ROAD 2222, BUILDING 1, STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730
Mailing Address - Country:US
Mailing Address - Phone:512-628-0465
Mailing Address - Fax:512-233-2711
Practice Address - Street 1:925 RUSH DR
Practice Address - Street 2:CENTRAL COLORADO DERMATOLOGY
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-9665
Practice Address - Country:US
Practice Address - Phone:719-539-4600
Practice Address - Fax:719-539-4629
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2023-02-24
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Provider Licenses
StateLicense IDTaxonomies
CO39785207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO457538Medicare ID - Type UnspecifiedMEDICARE NUMBER
COH59913Medicare UPIN