Provider Demographics
NPI:1982911590
Name:MCMAHON, TIMOTHY JOHN (PT, OCS)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:JOHN
Last Name:MCMAHON
Suffix:
Gender:M
Credentials:PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3001 MERCER UNIVERSITY DR
Mailing Address - Street 2:DAVIS BUILDING, SUITE 106
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-4115
Mailing Address - Country:US
Mailing Address - Phone:678-547-6778
Mailing Address - Fax:678-547-6202
Practice Address - Street 1:3001 MERCER UNIVERSITY DR
Practice Address - Street 2:DAVIS BUILDING, SUITE 106
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-4115
Practice Address - Country:US
Practice Address - Phone:678-547-6778
Practice Address - Fax:678-547-6202
Is Sole Proprietor?:No
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA003086225100000X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports