Provider Demographics
NPI:1801843271
Name:BOWERS, TIMOTHY KEEFE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:KEEFE
Last Name:BOWERS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:172 LINDEN DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2891
Mailing Address - Country:US
Mailing Address - Phone:540-723-8778
Mailing Address - Fax:540-723-8808
Practice Address - Street 1:172 LINDEN DR
Practice Address - Street 2:SUITE 105
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2891
Practice Address - Country:US
Practice Address - Phone:540-723-8778
Practice Address - Fax:540-723-8808
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2021-10-01
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101239217208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10362385Medicaid
VA239148OtherANTHEM BCBS
WV7300161000Medicaid
VAP00375414OtherMEDICARE RR
VA10362385Medicaid
VAP00375414OtherMEDICARE RR