Provider Demographics
NPI:1922161397
Name:BURKE, TIMOTHY F (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:F
Last Name:BURKE
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 1:801 E WILLIAMS AVE STE 2210
Mailing Address - Street 2:
Mailing Address - City:FALLON
Mailing Address - State:NV
Mailing Address - Zip Code:89406-3052
Mailing Address - Country:US
Mailing Address - Phone:775-867-7703
Mailing Address - Fax:775-423-2707
Practice Address - Street 1:801 E WILLIAMS AVE
Practice Address - Street 2:
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-3052
Practice Address - Country:US
Practice Address - Phone:775-867-7740
Practice Address - Fax:775-423-2707
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7313207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT00005941OtherBLUE CROSS & BLUE SHIELD
MT0021697Medicaid
NV1922161397Medicaid