Provider Demographics
NPI:1508501479
Name:FRANCE, TIMOTHY CLYDE
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:CLYDE
Last Name:FRANCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 TAYMOR RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-9520
Mailing Address - Country:US
Mailing Address - Phone:405-973-6502
Mailing Address - Fax:
Practice Address - Street 1:3650 TAYMOR RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-9520
Practice Address - Country:US
Practice Address - Phone:405-973-6502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-04
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider