Provider Demographics
NPI:1306988902
Name:JOINER, TIM S (DC)
Entity type:Individual
Prefix:
First Name:TIM
Middle Name:S
Last Name:JOINER
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 1:115 S TOWNSEND ST
Mailing Address - Street 2:
Mailing Address - City:MORGANFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42437-1470
Mailing Address - Country:US
Mailing Address - Phone:270-389-9555
Mailing Address - Fax:270-389-4922
Practice Address - Street 1:115 S TOWNSEND ST
Practice Address - Street 2:
Practice Address - City:MORGANFIELD
Practice Address - State:KY
Practice Address - Zip Code:42437-1470
Practice Address - Country:US
Practice Address - Phone:270-389-9555
Practice Address - Fax:270-389-4922
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2008-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4060111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0586Medicare PIN