Provider Demographics
NPI:1427094713
Name:BEYER, TIMOTHY EARLE (DO)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:EARLE
Last Name:BEYER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:570 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55057-2756
Mailing Address - Country:US
Mailing Address - Phone:507-301-3412
Mailing Address - Fax:507-301-3308
Practice Address - Street 1:570 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057-2756
Practice Address - Country:US
Practice Address - Phone:507-301-3412
Practice Address - Fax:507-301-3308
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN465232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN004954900Medicaid
MN260002760Medicare Oscar/Certification
MNG60700Medicare UPIN
MN004954900Medicaid
MN260002762Medicare Oscar/Certification