Individual provider · Type 1 NPI

Timothy Paul Quackenbush, PA-S

Student in an Organized Health Care Education/Training Program · Fort Benning, GA

NPI number 1194655647 Active

Practice location

6600 Van Aalst Blvd
Fort Benning, GA 31905-2102

Call (762) 408-2273 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1194655647

Timothy Paul Quackenbush, PA-S's National Provider Identifier is 1194655647, issued on May 19, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Fort Benning, GA. The record was last updated on May 19, 2026.