Individual
DR. TIMOTHY JACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1040 PARK AVE STE 200, BALTIMORE, MD 21201-5634
(443) 738-0300
(443) 738-0301
Mailing address
1040 PARK AVE STE 200, BALTIMORE, MD 21201-5634
(443) 738-0300
(443) 738-0301
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D0032712
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
062131500
—
MD
Enumeration date
11/05/2008
Last updated
10/06/2025
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