Provider Demographics
NPI:1306637699
Name:SIRK, TIMOTHY MARK II
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:MARK
Last Name:SIRK
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:KEYSER
Mailing Address - State:WV
Mailing Address - Zip Code:26726-2330
Mailing Address - Country:US
Mailing Address - Phone:304-209-2187
Mailing Address - Fax:
Practice Address - Street 1:350 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-2330
Practice Address - Country:US
Practice Address - Phone:304-209-2187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant