Provider Demographics
NPI:1770961849
Name:TONEY, TIMOTHY SCOTT JR (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:SCOTT
Last Name:TONEY
Suffix:JR
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:PSC 475 BOX 1871
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96350-1871
Mailing Address - Country:US
Mailing Address - Phone:046-816-5505
Mailing Address - Fax:
Practice Address - Street 1:U. S. NMRTC YOKOSUKA FPO
Practice Address - Street 2:FPO, AP 96350
Practice Address - City:YOKOSUKA
Practice Address - State:CA
Practice Address - Zip Code:96350
Practice Address - Country:US
Practice Address - Phone:619-532-6474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171000000X
VA0101260859208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No171000000XOther Service ProvidersMilitary Health Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAVAD0000Medicare UPIN