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General NPI Number Information
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NPI Number | 1427119478
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Entity Type | Individual
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Provider Name | TIMOTHY JOSHUA NIX D.C.
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Gender | Male
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 106 NORTH MAIN STREET
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City | RED OAK
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State | OK
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Zip | 74563-6506
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Country | US
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Telephone | 918-448-6054
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Fax |
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Provider Business Mailing Address
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Address Line | 12150 NE 155TH RD
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City | RED OAK
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State | OK
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Zip | 74563-5124
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Country | US
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Telephone | 918-448-6054
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 4045
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License Number State | OK
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