Provider Demographics
NPI:1275535080
Name:ADAIR, TIMOTHY JOE (DC)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:JOE
Last Name:ADAIR
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 1:833A WREN RD
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-2316
Mailing Address - Country:US
Mailing Address - Phone:615-239-8676
Mailing Address - Fax:615-239-8325
Practice Address - Street 1:833A WREN RD
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-2316
Practice Address - Country:US
Practice Address - Phone:615-239-8676
Practice Address - Fax:615-239-8325
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC1357111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3679317Medicare ID - Type Unspecified
TNU68021Medicare UPIN