Provider Demographics
NPI:1508828492
Name:TEMPLETON, TIMOTHY L (OD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:L
Last Name:TEMPLETON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18680 S NOGALES HWY
Mailing Address - Street 2:WAL-MART VISION CENTER
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-5284
Mailing Address - Country:US
Mailing Address - Phone:520-625-7949
Mailing Address - Fax:
Practice Address - Street 1:18680 S NOGALES HWY
Practice Address - Street 2:WAL-MART VISION CENTER
Practice Address - City:SAHUARITA
Practice Address - State:AZ
Practice Address - Zip Code:85614-5284
Practice Address - Country:US
Practice Address - Phone:520-625-7949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002856152W00000X
AZ1892152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist