Provider Demographics
NPI:1932589959
Name:GEORGE, TIMOTHY MORGAN (NP-C)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:MORGAN
Last Name:GEORGE
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 SOMERSET BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-3952
Mailing Address - Country:US
Mailing Address - Phone:304-725-2663
Mailing Address - Fax:
Practice Address - Street 1:912 SOMERSET BLVD STE 101
Practice Address - Street 2:
Practice Address - City:CHARLES TOWN
Practice Address - State:WV
Practice Address - Zip Code:25414-3952
Practice Address - Country:US
Practice Address - Phone:304-725-2663
Practice Address - Fax:304-724-0053
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV98711363LF0000X
MA2301792363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily