Provider Demographics
NPI:1215061452
Name:B. TIMOTHY SCHAEFFER MD PC
Entity type:Organization
Organization Name:B. TIMOTHY SCHAEFFER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BERTON
Authorized Official - Middle Name:TIMOTHY
Authorized Official - Last Name:SCHAEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-894-1546
Mailing Address - Street 1:PO BOX 756
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:GA
Mailing Address - Zip Code:30511-0756
Mailing Address - Country:US
Mailing Address - Phone:706-894-1546
Mailing Address - Fax:706-894-1548
Practice Address - Street 1:214 HOSPITAL CIR
Practice Address - Street 2:
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512-3102
Practice Address - Country:US
Practice Address - Phone:706-894-1546
Practice Address - Fax:706-894-1548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA010278207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP4494Medicare PIN