Provider Demographics
NPI:1427497791
Name:LUMPKIN, TIMOTHY BRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:BRIAN
Last Name:LUMPKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4901 FOREST PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-1402
Mailing Address - Country:US
Mailing Address - Phone:314-362-5060
Mailing Address - Fax:
Practice Address - Street 1:12300 MCCRACKEN RD STE 259
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2914
Practice Address - Country:US
Practice Address - Phone:216-587-8830
Practice Address - Fax:216-587-8944
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.129091207RP1001X
MO2013018168207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine