Provider Demographics
NPI:1982666897
Name:POYNTER, TIMOTHY W (ARNP)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:W
Last Name:POYNTER
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 HOSPITAL WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2872
Mailing Address - Country:US
Mailing Address - Phone:606-451-2671
Mailing Address - Fax:606-451-2641
Practice Address - Street 1:350 HOSPITAL WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2872
Practice Address - Country:US
Practice Address - Phone:606-451-2671
Practice Address - Fax:606-451-2641
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1044110363L00000X
KY2569P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00440942OtherRAILROAD MEDICARE
000000504504OtherANTHEM
1167822OtherCHA HEALTH
S60005OtherCUMBERLAND HEALTHCARE
KY78025699Medicaid
P00440942OtherRAILROAD MEDICARE
KY78025699Medicaid