Individual
TIMOTHY A URBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
208 MEDICAL PARK BLVD, BRISTOL, TN 37620-7343
(423) 989-4050
(423) 990-3044
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 989-4050
(423) 989-3044
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
P1987
TN
103TC0700X
Clinical Psychologist
Primary
P1987
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3714470
GROUP MEDICARE PIN
TN
Enumeration date
02/03/2010
Last updated
04/01/2013
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