Individual
DR. TIMOTHY WIERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
484 GOLDEN AUTUMN WAY STE 201, BOWLING GREEN, KY 42103
(270) 783-3340
(270) 780-0492
Mailing address
201 PARK ST, BOWLING GREEN, KY 42101-1759
(270) 781-5111
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
26264
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64262645
—
KY
Enumeration date
06/22/2005
Last updated
05/13/2019
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