Provider Demographics
NPI:1134129901
Name:JOPLIN, TIMOTHY SCOTT (DC)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:SCOTT
Last Name:JOPLIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 N FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-5627
Mailing Address - Country:US
Mailing Address - Phone:573-335-9229
Mailing Address - Fax:573-339-0994
Practice Address - Street 1:307 N FREDERICK ST
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-5627
Practice Address - Country:US
Practice Address - Phone:573-335-9229
Practice Address - Fax:573-339-0994
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-22
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004984111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO350055836Medicare ID - Type UnspecifiedRAIL ROAD MEDICARE
MO000030185Medicare ID - Type Unspecified