Provider Demographics
NPI:1659461820
Name:MCPHERSON, TIMOTHY I (OT)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:I
Last Name:MCPHERSON
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3902
Mailing Address - Country:US
Mailing Address - Phone:724-463-7478
Mailing Address - Fax:724-463-0931
Practice Address - Street 1:800 BETHLEHEM PIKE
Practice Address - Street 2:SUITE 2
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1660
Practice Address - Country:US
Practice Address - Phone:215-257-3900
Practice Address - Fax:215-257-7545
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC004545L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1565526OtherHIGHMARK BLUE SHIELD
PA2246375000OtherINDEPENDENCE BLUE CROSS
PA267181OtherHEALTH AMER/HEALTH ASSUR.
PA396749Medicare ID - Type UnspecifiedMEDICARE