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NPI Code Detail

MEDICARE: MR. TIMOTHY SUTTON OCHS CRNA, APN

MEDICARE: MR. TIMOTHY SUTTON OCHS CRNA, APN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist130201TN
2367500000XCertified Registered Nurse Anesthetist1326382FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3430059007OTHERTNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13154746OTHERTNBLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114920105
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TIMOTHY SUTTON OCHS CRNA, APN
Provider Business Mailing Address
First Line : PO BOX 965
Second Line :
City : HARRIMAN
State : TN
Zip : 37748-0965
Country : US
Telephone Number : 865-590-0933
Fax Number : 865-590-0933
Provider Business Practice Location Address
First Line : 1236 KNOXVILLE HWY
Second Line :
City : WARTBURG
State : TN
Zip : 37887-4200
Country : US
Telephone Number : 423-346-6556
Fax Number : 423-346-7541
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 03/11/2008

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