Provider Demographics
NPI:1396449823
Name:DEAN, TIMOTHY SCOTT JR (DO)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:SCOTT
Last Name:DEAN
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:TJ
Other - Middle Name:
Other - Last Name:DEAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4439 STATE ROUTE 159 STE 150
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-7833
Mailing Address - Country:US
Mailing Address - Phone:740-779-7070
Mailing Address - Fax:740-779-8449
Practice Address - Street 1:4439 STATE ROUTE 159 STE 150
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-7833
Practice Address - Country:US
Practice Address - Phone:740-779-7070
Practice Address - Fax:740-779-8449
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH58.033487207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty