Provider Demographics
NPI:1831174390
Name:TOMS, TIMOTHY R (DO)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:R
Last Name:TOMS
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:PO BOX 10583
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35202-0583
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1815 HAND AVE
Practice Address - Street 2:
Practice Address - City:BAY MINETTE
Practice Address - State:AL
Practice Address - Zip Code:36507-4110
Practice Address - Country:US
Practice Address - Phone:251-937-5521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY02283207Q00000X
ALDO.339207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-06892OtherBCBS
AL009911817Medicaid
AL009911821Medicaid
AL009911818Medicaid
KY64022833Medicaid
AL009911819Medicaid
AL1831174390OtherTRICARE SOUTH
AL510-06886OtherBCBS
AL510-06888OtherBCBS
AL51006894OtherBCBS
AL51006894OtherBCBS
AL510-06888OtherBCBS
KY0557606Medicare ID - Type Unspecified
AL009911821Medicaid