Provider Demographics
NPI:1750499968
Name:JANA, TIMOTHY (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:JANA
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:PO BOX 2500
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24402-2500
Mailing Address - Country:US
Mailing Address - Phone:540-332-8211
Mailing Address - Fax:
Practice Address - Street 1:103 VALLEY CENTER DR
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-5080
Practice Address - Country:US
Practice Address - Phone:540-332-8200
Practice Address - Fax:540-332-8197
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012400062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA011365C61Medicare ID - Type Unspecified
163159Medicare UPIN