Individual provider · Type 1 NPI

Timothy Ford, PA-C

Surgical Physician Assistant · South Charleston, WV

NPI number 1750709226 Active

Practice location

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311

Call (304) 766-3600 Map

Mailing address

11157 Charleston Rd
Red House, WV 25168

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X00429 (WV)

Surgical Physician Assistant: Definition to come...

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About NPI 1750709226

Timothy Ford, PA-C's National Provider Identifier is 1750709226, issued on Apr 2, 2014. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in South Charleston, WV. The record was last updated on Apr 2, 2014.