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NPI Code Detail

MEDICARE: TIMOTHY BUTCHER

MEDICARE: TIMOTHY BUTCHER
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
1225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15452OTHERTNLICENSE #

General Provider Information

NPI Number : 1013024272
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY BUTCHER
Provider Business Mailing Address
First Line : 7228 NORRIS FWY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37918-5744
Country : US
Telephone Number : 865-377-3176
Fax Number : 865-377-3187
Provider Business Practice Location Address
First Line : 7228 NORRIS FWY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37918-5744
Country : US
Telephone Number : 865-377-3176
Fax Number : 865-377-3187
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2006
Last Update Date : 03/13/2017

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