Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Timothy Douglas, PA-C

Individual provider Medical Physician Assistant · NPI 1841603529

Timothy Douglas, PA-C is a Physician Assistant in South Charleston, West Virginia. Qualified in 2014, 12 years ago. Practices with West Virginia Dermatology and Skin Surgery Center, a 6-clinician group and accepts Medicare assignment.

Years since qualifying
12
In the registry since
2014
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4202 McCorkle Ave SW Ste 200
South Charleston, WV 25309-1513
Phone: (304) 925-7546
Fax: (681) 205-8369
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1841603529
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 10, 2014
Last updated in NPPESSeptember 30, 2020
Certification dateSeptember 30, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice West Virginia Dermatology And Skin Surgery Center — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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