Individual
DR. TIMOTHY D LAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1201 BROAD ROCK BLVD, RICHMOND, VA 23249-0001
(804) 675-5455
(804) 675-5223
Mailing address
1201 BROAD ROCK BLVD, RICHMOND, VA 23249-0001
(804) 675-5455
(804) 675-5223
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
2006-00544
NC
2081P0004X
Spinal Cord Injury Medicine Physician
Primary
2006-00544
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14228
NCBCBS
NC
05
—
5903885
—
NC
05
—
N0054A
—
SC
Enumeration date
07/19/2006
Last updated
04/29/2013
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