Individual
DR. TIMOTHY JOSEPH FLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
320 WARNER DR, LEWISTON, ID 83501
(208) 743-3523
(208) 746-8741
Mailing address
320 WARNER DR, LEWISTON, ID 83501
(208) 743-3523
(208) 746-8741
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
M6831
ID
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
MD00032793
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00001000102
REGENCE
ID
05
—
003688100
—
ID
05
—
8177388
—
WA
01
—
DA673
BLUE CROSS OF IDAHO
ID
Enumeration date
09/20/2005
Last updated
06/24/2016
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