Provider Demographics
NPI:1225315047
Name:ATKINSON, TIMOTHY LYNN (ATC)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:LYNN
Last Name:ATKINSON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 DEERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:AR
Mailing Address - Zip Code:71602-9218
Mailing Address - Country:US
Mailing Address - Phone:870-692-5849
Mailing Address - Fax:
Practice Address - Street 1:700 BULLDOG DR
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:AR
Practice Address - Zip Code:71602-9563
Practice Address - Country:US
Practice Address - Phone:870-794-5570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAT1702255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer