Individual
TIFFANY K THYMIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
252 RURAL ACRES DR, BECKLEY, WV 25801-3503
(304) 252-8551
(304) 252-1790
Mailing address
252 RURAL ACRES DR, BECKLEY, WV 25801-3503
(304) 252-8551
(304) 252-1790
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1802
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1806250000
—
WV
01
—
321726
CARELINK
—
05
—
58588
—
WV
05
—
90036
—
WV
01
—
H54912
HEALTH NET
—
01
—
P00389007
MEDICARE TRAVELERS RAILRO
WV
Enumeration date
09/29/2006
Last updated
07/10/2007
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