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NPI Code Detail

MEDICARE: CLIFF TIMMONS

MEDICARE: CLIFF TIMMONS
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
1247200000XOther Technician00689341OK

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1371803OTHEROKMEDICARE

General Provider Information

NPI Number : 1619962248
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLIFF TIMMONS
Provider Business Mailing Address
First Line : 1334 N LANSING AVE
Second Line :
City : TULSA
State : OK
Zip : 74106-5907
Country : US
Telephone Number : 918-587-2171
Fax Number : 918-582-0529
Provider Business Practice Location Address
First Line : 1334 N LANSING AVE
Second Line :
City : TULSA
State : OK
Zip : 74106-5907
Country : US
Telephone Number : 918-587-2171
Fax Number : 918-582-0529
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2005
Last Update Date : 12/27/2007

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Directions to “ CLIFF TIMMONS ” Practice Location

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