Individual
DR. TIMOTHY R HASTINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1557 ROBERTS DR STE 225, CREDENTIALING DEPARTMENT, JACKSONVILLE BEACH, FL 32250
(904) 241-1204
(904) 241-7331
Mailing address
PO BOX 117345, ATLANTA, GA 30368-7345
(904) 346-3465
(904) 858-6489
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME101641
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000389500
—
FL
01
—
P00680402
RAILROAD MEDICARE
FL
Enumeration date
02/15/2006
Last updated
03/25/2021
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