Provider Demographics
NPI:1568151363
Name:TIMMIS, CHRISTIAN XAVIER (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:XAVIER
Last Name:TIMMIS
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 1:917 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-6527
Mailing Address - Country:US
Mailing Address - Phone:423-439-6464
Mailing Address - Fax:
Practice Address - Street 1:917 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-6527
Practice Address - Country:US
Practice Address - Phone:423-439-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program