Provider Demographics
NPI:1972845121
Name:PEARSON, TIMOTHY (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:PEARSON
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 1:5 REGIONAL CIR
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9863
Mailing Address - Country:US
Mailing Address - Phone:910-295-5567
Mailing Address - Fax:910-295-3315
Practice Address - Street 1:5 REGIONAL CIR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-9863
Practice Address - Country:US
Practice Address - Phone:910-295-5567
Practice Address - Fax:910-295-3315
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-25
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0082862207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology