Provider Demographics
NPI:1114920105
Name:OCHS, TIMOTHY SUTTON (CRNA, APN)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:SUTTON
Last Name:OCHS
Suffix:
Gender:M
Credentials:CRNA, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 965
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-0965
Mailing Address - Country:US
Mailing Address - Phone:865-590-0933
Mailing Address - Fax:865-590-0933
Practice Address - Street 1:1236 KNOXVILLE HWY
Practice Address - Street 2:
Practice Address - City:WARTBURG
Practice Address - State:TN
Practice Address - Zip Code:37887-4200
Practice Address - Country:US
Practice Address - Phone:423-346-6556
Practice Address - Fax:423-346-7541
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN130201367500000X
FL1326382367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3154746OtherBLUE SHIELD
TN3630889Medicaid
TN430059007OtherRAILROAD MEDICARE
TN3630889Medicare ID - Type Unspecified
TNR03397Medicare UPIN