Provider Demographics
NPI:1306227780
Name:RATLIFF, TIM MICHAEL (DO)
Entity Type:Individual
Prefix:
First Name:TIM
Middle Name:MICHAEL
Last Name:RATLIFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:18700 N 64TH DR STE 301
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7114
Mailing Address - Country:US
Mailing Address - Phone:602-726-8788
Mailing Address - Fax:480-420-0732
Practice Address - Street 1:18700 N 64TH DR STE 301
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-7114
Practice Address - Country:US
Practice Address - Phone:602-726-8788
Practice Address - Fax:480-420-0732
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2019-10-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ008041207QS0010X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine