Healthcare Provider Details

I. General information

NPI: 1982095840
Provider Name (Legal Business Name): FLEMING TIMMERMAN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2015
Last Update Date: 02/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1363 BROAD ST
AUGUSTA GA
30901-1055
US

IV. Provider business mailing address

1363 BROAD ST
AUGUSTA GA
30901-1055
US

V. Phone/Fax

Practice location:
  • Phone: 706-722-2621
  • Fax:
Mailing address:
  • Phone: 706-722-2621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHADS000322
License Number StateGA

VIII. Authorized Official

Name: DAVID TIMMERMAN
Title or Position: OWNER
Credential:
Phone: 706-722-2621