Individual
TIMOTHY L BEWLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
2221 WELLNESS WAY, LAMAR, CO 81052-3867
(719) 336-6976
(719) 336-1221
Mailing address
201 KENDALL DR, LAMAR, CO 81052-3939
(719) 336-0261
(719) 336-0265
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 362
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78484260
—
CO
Enumeration date
11/28/2005
Last updated
03/07/2023
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