Provider Demographics
NPI:1891743498
Name:TIMMONS, JOHN W (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:TIMMONS
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 1:220 CAMPUS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2888
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:540-536-0235
Practice Address - Street 1:13737 SPOTSWOOD TRL
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:VA
Practice Address - Zip Code:22827-3200
Practice Address - Country:US
Practice Address - Phone:540-298-1200
Practice Address - Fax:540-298-1144
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043469207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
08107000000OtherSOUTHERN HEALTH
106059OtherANTHEM/BCBS
VA5615861Medicaid
080080292OtherRAILROAD MEDICARE
VA1000870001OtherDME PROVIDER
VA22579OtherOPTIMA
700103083OtherCIGNA
VA5615861Medicaid
VA080005111Medicare PIN
106059OtherANTHEM/BCBS