Provider Demographics
NPI:1841393840
Name:ADAMCRYK, TIMOTHY (MD)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:
Last Name:ADAMCRYK
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 1:1204 CORNELL DR
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-3509
Mailing Address - Country:US
Mailing Address - Phone:850-814-1815
Mailing Address - Fax:850-230-4977
Practice Address - Street 1:20370 NE BURNS AVE
Practice Address - Street 2:
Practice Address - City:BLOUNTSTOWN
Practice Address - State:FL
Practice Address - Zip Code:32424-1045
Practice Address - Country:US
Practice Address - Phone:850-674-5411
Practice Address - Fax:850-237-3010
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81036207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH32139Medicare UPIN