Provider Demographics
NPI:1316917586
Name:FRANCIS, TIMOTHY JAMES (IDC)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:JAMES
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:MR
Other - First Name:TIMOTHY
Other - Middle Name:JAMES
Other - Last Name:FRANCIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:IDC
Mailing Address - Street 1:5722 INTEGRITY DR
Mailing Address - Street 2:BLDG S771
Mailing Address - City:MILLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38054-5028
Mailing Address - Country:US
Mailing Address - Phone:901-874-6100
Mailing Address - Fax:901-874-6110
Practice Address - Street 1:5722 INTEGRITY DR
Practice Address - Street 2:BLDG S771
Practice Address - City:MILLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38054-5028
Practice Address - Country:US
Practice Address - Phone:901-874-6100
Practice Address - Fax:901-874-6110
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman