Provider Demographics
NPI:1285741371
Name:SARGEANT, TIMOTHY E (DC)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:E
Last Name:SARGEANT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6903 TRICK LN SE
Mailing Address - Street 2:
Mailing Address - City:OWENS CROSS ROADS
Mailing Address - State:AL
Mailing Address - Zip Code:35763-8767
Mailing Address - Country:US
Mailing Address - Phone:256-506-6091
Mailing Address - Fax:
Practice Address - Street 1:810 SHONEY DR SW
Practice Address - Street 2:SUITE 105
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5436
Practice Address - Country:US
Practice Address - Phone:256-461-7760
Practice Address - Fax:256-489-9568
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1792111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051518251Medicare ID - Type Unspecified
ALV01864Medicare UPIN