Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | OS015223 | PA |
N | 207VX0201X | Gynecologic Oncologist | OT013710 | PA |
Y | 207VX0201X | Gynecologic Oncologist | P6032 | TX |
NPI | 1073659306 |
---|---|
Provider Name | Dr. Timothy Chad Mccormick |
First Address | Dallas, TX 75284-4658 |
Second Address | Temple, TX 76508-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 28/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1024859880001 | (05) | PA |
1590832 | GATEWAY-WMG (01) | PA |
2516221 | HIGHMARK BLUE SHIELD-WMG (01) | PA |
30077866 | AMERIHEALTH MERCY-WMG (01) | PA |
307945 | UNISON-WMG (01) | PA |
415272 | UMPC-WMG (01) | PA |
968832 | CAREFIRST MD BCBS-WMG (01) | PA |