Provider Demographics
NPI:1912961715
Name:WEBB, TIMOTHY SCOTT (DO)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:SCOTT
Last Name:WEBB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:T
Other - Middle Name:SCOTT
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:252 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:HOISINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67544-1725
Mailing Address - Country:US
Mailing Address - Phone:620-653-2386
Mailing Address - Fax:620-653-4186
Practice Address - Street 1:252 W 9TH ST STE A
Practice Address - Street 2:
Practice Address - City:HOISINGTON
Practice Address - State:KS
Practice Address - Zip Code:67544-1700
Practice Address - Country:US
Practice Address - Phone:620-653-2386
Practice Address - Fax:620-653-4186
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-22573207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100230410BMedicaid
046752Medicare ID - Type Unspecified
E97524Medicare UPIN