Healthcare Provider Details

I. General information

NPI: 1316917586
Provider Name (Legal Business Name): TIMOTHY JAMES FRANCIS IDC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

Provider Other Name: TIMOTHY JAMES FRANCIS IDC

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5722 INTEGRITY DR BLDG S771
MILLINGTON TN
38054-5028
US

IV. Provider business mailing address

5722 INTEGRITY DR BLDG S771
MILLINGTON TN
38054-5028
US

V. Phone/Fax

Practice location:
  • Phone: 901-874-6100
  • Fax: 901-874-6110
Mailing address:
  • Phone: 901-874-6100
  • Fax: 901-874-6110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: