Provider Demographics
NPI:1194706036
Name:WESTER, TIMOTHY MERLE (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:MERLE
Last Name:WESTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 420TH ST
Mailing Address - Street 2:
Mailing Address - City:LARRABEE
Mailing Address - State:IA
Mailing Address - Zip Code:51029-7026
Mailing Address - Country:US
Mailing Address - Phone:712-446-2342
Mailing Address - Fax:
Practice Address - Street 1:231 N 8TH AVE W
Practice Address - Street 2:
Practice Address - City:HARTLEY
Practice Address - State:IA
Practice Address - Zip Code:51346-1005
Practice Address - Country:US
Practice Address - Phone:712-928-2820
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23075207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAG58007Medicare UPIN