Provider Demographics
NPI:1922469519
Name:WAUGH, TIMOTHY JOSEPH JR (ATC)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:JOSEPH
Last Name:WAUGH
Suffix:JR
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:JOEY
Other - Middle Name:
Other - Last Name:WAUGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:204 PROVIDENCE HILL DR APT 189
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-2295
Mailing Address - Country:US
Mailing Address - Phone:513-393-1417
Mailing Address - Fax:
Practice Address - Street 1:110 HILLTOP AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40506-4710
Practice Address - Country:US
Practice Address - Phone:859-257-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-10
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer