Provider Demographics
NPI:1740233659
Name:PIEARSON, TIMOTHY (DO)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:
Last Name:PIEARSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 SE KENT ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:50849-9454
Mailing Address - Country:US
Mailing Address - Phone:641-743-2123
Mailing Address - Fax:641-743-7294
Practice Address - Street 1:609 SE KENT ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IA
Practice Address - Zip Code:50849-9454
Practice Address - Country:US
Practice Address - Phone:641-743-6189
Practice Address - Fax:641-743-6217
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA3543207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1432153Medicaid
IA37448OtherBLUE CROSS/BLUE SHIELD
IAI03434Medicare UPIN
IAI14002Medicare PIN