Provider Demographics
NPI:1659807493
Name:WEE, TIMOTHY ROBERT (RPH)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:ROBERT
Last Name:WEE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 W SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46901-4108
Mailing Address - Country:US
Mailing Address - Phone:765-452-4437
Mailing Address - Fax:
Practice Address - Street 1:2340 W SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-4108
Practice Address - Country:US
Practice Address - Phone:765-452-4437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49478183500000X
IN26019040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist