DR. TIMOTHY NORRIS WEBSTER PHD

Clinical Neuropsychologist

Winston Salem, North Carolina

Provider NPI: 1629033006

Provider Information:
DR. TIMOTHY NORRIS WEBSTER PHD
Gender: M
Not Sole Proprietor

Practice Location:
160 KIMEL FOREST DR STE 100 WINSTON SALEM, NC 27103 US
Tel: 336-770-6451  Fax: 336-714-6475

Business Mailing Address:
160 KIMEL FOREST DR STE 100 WINSTON SALEM, NC 27103 US
Tel: 336-770-6451  Fax: 336-714-6475

Entity Type: Individual

Taxonomy:

Primary	Code	Category/Description	State	License Number
N	103G00000X	Behavioral Health & Social Service Providers Clinical Neuropsychologist	NC	635
Y	103T00000X	Behavioral Health & Social Service Providers Psychologist	NC	635
N	103TB0200X	Behavioral Health & Social Service Providers Psychologist	NC	635
N	103TC0700X	Behavioral Health & Social Service Providers Psychologist	NC	635
N	103TH0100X	Behavioral Health & Social Service Providers Psychologist	NC	635
N	103TP2701X	Behavioral Health & Social Service Providers Psychologist	NC	635
N	103TR0400X	Behavioral Health & Social Service Providers Psychologist	NC	635

Other Provider Identifiers:

Issuer	Number	State	Type
	6000280	NC	05
BCBS PROVIDER ID	04862	NC	01

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin

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