Provider Demographics
NPI:1922001437
Name:HEYD, TIMOTHY J (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:J
Last Name:HEYD
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 1:9549 MONTGOMERY RD 100
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-7238
Mailing Address - Country:US
Mailing Address - Phone:513-489-3737
Mailing Address - Fax:513-984-3796
Practice Address - Street 1:416 S EAST ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-2378
Practice Address - Country:US
Practice Address - Phone:513-695-1228
Practice Address - Fax:513-695-2941
Is Sole Proprietor?:No
Enumeration Date:2005-05-30
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34063863H207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0164398Medicaid
OH000000374073OtherUNICARE
OH000000374073OtherANTHEM
OH421534506091OtherCARESOURCE
OH4262626OtherAETNA
NDD6386303OtherHUMANA/CHOICECARE
OH080188836OtherRAILROAD MEDICARE
OH203006OtherNATIONWIDE HEALTH PLAN
OH421534506091OtherCARESOURCE
OHHE0899052Medicare PIN