Provider Demographics
NPI:1932183019
Name:WEINZAPFEL, TIMOTHY G (MSPT, OCS)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:G
Last Name:WEINZAPFEL
Suffix:
Gender:M
Credentials:MSPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 E INDIANA ST
Mailing Address - Street 2:STE. 102
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-2794
Mailing Address - Country:US
Mailing Address - Phone:812-476-0409
Mailing Address - Fax:812-476-1016
Practice Address - Street 1:5625 PEARL DR
Practice Address - Street 2:STE. 100
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-8106
Practice Address - Country:US
Practice Address - Phone:812-759-7493
Practice Address - Fax:812-401-2346
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05005187A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200829410Medicaid
IN000000178770OtherBLUE CROSS BLUE SHIELD
IN200829410Medicaid
IN650024933Medicare UPIN
IN000000178770OtherBLUE CROSS BLUE SHIELD