Provider Demographics
NPI:1952346603
Name:HINDMARSH, TIMOTHY E (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:E
Last Name:HINDMARSH
Suffix:
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 1:25668 RICE RD
Mailing Address - Street 2:
Mailing Address - City:SWEET HOME
Mailing Address - State:OR
Mailing Address - Zip Code:97386-9650
Mailing Address - Country:US
Mailing Address - Phone:541-979-9725
Mailing Address - Fax:
Practice Address - Street 1:1023 MAIN ST
Practice Address - Street 2:
Practice Address - City:SWEET HOME
Practice Address - State:OR
Practice Address - Zip Code:97386-1515
Practice Address - Country:US
Practice Address - Phone:541-255-1234
Practice Address - Fax:541-255-1366
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2023-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD18704207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORF95005Medicare UPIN