Provider Demographics
NPI:1518937846
Name:TOBIN, TIMOTHY PAUL (OD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:PAUL
Last Name:TOBIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 BAYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-1510
Mailing Address - Country:US
Mailing Address - Phone:757-363-7883
Mailing Address - Fax:
Practice Address - Street 1:BRANCH MEDICAL CLINIC, LITTLE CREEK
Practice Address - Street 2:1035 NIDER BLVD STE 100
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23521
Practice Address - Country:US
Practice Address - Phone:757-314-7414
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000562152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist