MEDICARE: TIMOTHY SCOTT JOPLIN DC

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
1	111N00000X	Chiropractor	004984	MO

General Provider Information

NPI Number	:	1134129901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY SCOTT JOPLIN DC

Provider Business Mailing Address
First Line	:	307 N FREDERICK ST
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63701-5627
Country	:	US
Telephone Number	:	573-335-9229
Fax Number	:	573-339-0994

Provider Business Practice Location Address
First Line	:	307 N FREDERICK ST
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63701-5627
Country	:	US
Telephone Number	:	573-335-9229
Fax Number	:	573-339-0994

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	04/17/2009

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