Individual
DR. TIMOTHY JOSEPH QUILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
135 PROFESSIONAL PARK DR, CONWAY, SC 29526-9261
(843) 347-8765
(843) 236-4746
Mailing address
135 PROFESSIONAL PARK DR, CONWAY, SC 29526-9261
(843) 347-8765
(843) 236-4746
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
14869
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
774449
WELLCARE
SC
01
—
80023042
SELECT HEALTH
SC
05
—
890585W
—
NC
05
—
GP4522
—
SC
01
—
P00360562
RAILROAD MEDICARE
SC
Enumeration date
05/24/2006
Last updated
04/30/2026
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