Provider Demographics
NPI:1811071566
Name:LAWVER, TIMOTHY IVIN (DO)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:IVIN
Last Name:LAWVER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 OREGON ST
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-3201
Mailing Address - Country:US
Mailing Address - Phone:707-648-2200
Mailing Address - Fax:
Practice Address - Street 1:525 OREGON ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-3201
Practice Address - Country:US
Practice Address - Phone:707-648-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH58-0021962084P0800X
CA104412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry