Provider Demographics
NPI:1528032869
Name:P SCOTT TIMKO DC PLLC
Entity Type:Organization
Organization Name:P SCOTT TIMKO DC PLLC
Other - Org Name:PALMS CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:P
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:TIMKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-863-3345
Mailing Address - Street 1:2814 W BELL RD
Mailing Address - Street 2:STE 1470
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053
Mailing Address - Country:US
Mailing Address - Phone:602-863-3345
Mailing Address - Fax:602-863-0949
Practice Address - Street 1:2814 W BELL RD
Practice Address - Street 2:STE 1470
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053
Practice Address - Country:US
Practice Address - Phone:602-863-3345
Practice Address - Fax:602-863-0949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5748111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U76513Medicare UPIN
AZZ72964Medicare PIN