Provider Demographics
NPI:1659489177
Name:HEILMAN, TIMOTHY JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JOSEPH
Last Name:HEILMAN
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 1:995 TAHOE BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:INCLINE VILLAGE
Mailing Address - State:NV
Mailing Address - Zip Code:89451-9500
Mailing Address - Country:US
Mailing Address - Phone:775-833-2929
Mailing Address - Fax:775-833-0277
Practice Address - Street 1:995 TAHOE BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:INCLINE VILLAGE
Practice Address - State:NV
Practice Address - Zip Code:89451-9500
Practice Address - Country:US
Practice Address - Phone:775-833-2929
Practice Address - Fax:775-833-0277
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9689207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E25270Medicare UPIN
35289Medicare ID - Type Unspecified