Provider Demographics
NPI:1174725345
Name:CAREY, TIMOTHY MITCH (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:MITCH
Last Name:CAREY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-0658
Mailing Address - Country:US
Mailing Address - Phone:770-718-1122
Mailing Address - Fax:770-535-7445
Practice Address - Street 1:725 JESSE JEWELL PKWY SE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3834
Practice Address - Country:US
Practice Address - Phone:770-297-5700
Practice Address - Fax:770-718-1187
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA059381207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA9474371OtherMULTIPLAN
GA9929041OtherAETNA
GA2789720OtherUHC
GA52205947OtherBCBS
4660355OtherCIGNA
GA880605214AMedicaid
GAP00447452OtherMEDICARE RAILROAD
GA01054267OtherAMERIGROUP
GA391141OtherWELLCARE
GA880605214AOtherPEACH STATE
4660355OtherCIGNA