Provider Demographics
NPI:1235342312
Name:HALSTEAD, TIMOTHY JAMES (DVM)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:JAMES
Last Name:HALSTEAD
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5221 PARSONS RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MI
Mailing Address - Zip Code:49237-9783
Mailing Address - Country:US
Mailing Address - Phone:517-524-8833
Mailing Address - Fax:
Practice Address - Street 1:2300 WILDWOOD AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-3948
Practice Address - Country:US
Practice Address - Phone:517-784-8457
Practice Address - Fax:517-784-9767
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6918174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian