Provider Demographics
NPI:1073147153
Name:CHEVES, TIMOTHY (PA-C)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:CHEVES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9355 N OODHAM WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-9018
Mailing Address - Country:US
Mailing Address - Phone:520-609-8831
Mailing Address - Fax:
Practice Address - Street 1:6567 E CARONDELET DR STE 305
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-6160
Practice Address - Country:US
Practice Address - Phone:520-881-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2020-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7835207T00000X
AZ1171058363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery