Provider Demographics
NPI:1629035407
Name:VEST, TIMOTHY KEITH (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:KEITH
Last Name:VEST
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 1:1871 EVELYN BYRD AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3487
Mailing Address - Country:US
Mailing Address - Phone:540-434-0559
Mailing Address - Fax:540-434-1348
Practice Address - Street 1:1871 EVELYN BYRD AVE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3487
Practice Address - Country:US
Practice Address - Phone:540-434-0559
Practice Address - Fax:540-434-1348
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101033977207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA027598OtherANTHEM BLUE SHIELD
VA100003650OtherRAILROAD MEDICARE
VA006026737Medicaid
VA027598OtherANTHEM BLUE SHIELD
VA100000016Medicare ID - Type Unspecified