Provider Demographics
NPI:1558171587
Name:TIMMONS, AARON
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:TIMMONS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8594 HERITAGE PL
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48204-3592
Mailing Address - Country:US
Mailing Address - Phone:248-483-1246
Mailing Address - Fax:
Practice Address - Street 1:8594 HERITAGE PL
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48204-3592
Practice Address - Country:US
Practice Address - Phone:248-483-1246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker