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Contact Information

TIMOTHY J MCCORMICK, DO
12443 SAN JOSE BOULEVARD
SUITE 704
JACKSONVILLE, FL32223
 Phone: 904-288-8886
 Fax: 904-288-8331
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Medicine

2083X0100X 84 Physician/Preventive Medicine
Indicates primary specialty

NPI Profile & details for TIMOTHY J MCCORMICK · (Male)

NPI Number 1407069248
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 05/08/2007
Last updated 07/21/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # OS6196
  • NE License # 160
  • NM License # 84-248
  • NM License # A-794-84
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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