Provider Demographics
NPI:1528083821
Name:MARLOW, WILLIAM TIMOTHY (PT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:TIMOTHY
Last Name:MARLOW
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:1394 BATTLEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:FT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-4010
Practice Address - Country:US
Practice Address - Phone:706-858-0252
Practice Address - Fax:706-858-0323
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT2457225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP4895Medicare ID - Type UnspecifiedGROUP NUMBER
GA65BBDQJMedicare ID - Type Unspecified