Provider Demographics
NPI:1356642755
Name:PAXTON, TIMOTHY X (DO)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:X
Last Name:PAXTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FOSTER AVE
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:GIBBSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08026-1162
Mailing Address - Country:US
Mailing Address - Phone:856-761-5840
Mailing Address - Fax:
Practice Address - Street 1:10 FOSTER AVE
Practice Address - Street 2:SUITE 3A
Practice Address - City:GIBBSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08026-1162
Practice Address - Country:US
Practice Address - Phone:856-761-5840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08683900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine