Organization
TIM THISTLETHWAITE, M.D. PLLC
Active
Organization
TIM THISTLETHWAITE, M.D. PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIM L THISTLETHWAITE M.D. (OWNER)
(304) 205-5207
Entity
Organization
Contact information
Practice address
100 PEYTON WAY, SUITE 100, CHARLESTON, WV 25309-8767
(304) 205-5207
(304) 205-5318
Mailing address
100 PEYTON WAY, SUITE 100, CHARLESTON, WV 25309-8767
(304) 205-5207
(304) 205-5318
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1225
WV
2084P0800X
Psychiatry Physician
Primary
17498
WV
Other
Enumeration date
10/03/2006
Last updated
10/04/2013
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