Provider Demographics
NPI:1558496828
Name:WITZIGREUTER, TIMOTHY MAX SR (OPA-C)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:MAX
Last Name:WITZIGREUTER
Suffix:SR
Gender:M
Credentials:OPA-C
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Mailing Address - Street 1:1219 TOMAHAWK TRCE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-6443
Mailing Address - Country:US
Mailing Address - Phone:615-418-1446
Mailing Address - Fax:
Practice Address - Street 1:400 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-3837
Practice Address - Country:US
Practice Address - Phone:615-369-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant