Provider Demographics
NPI:1134428808
Name:ATKINSON, TIMOTHY HAIL (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:HAIL
Last Name:ATKINSON
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 1:101 MEDICAL HEIGHTS DR
Mailing Address - Street 2:STE A
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-4137
Mailing Address - Country:US
Mailing Address - Phone:502-223-5758
Mailing Address - Fax:502-223-0047
Practice Address - Street 1:101 MEDICAL HEIGHTS DR
Practice Address - Street 2:STE A
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-4137
Practice Address - Country:US
Practice Address - Phone:502-223-5758
Practice Address - Fax:502-223-0047
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KY49140208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0169Medicare PIN