Provider Demographics
NPI:1578575353
Name:NAGEL, TIMOTHY (DC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:
Last Name:NAGEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-5801
Mailing Address - Country:US
Mailing Address - Phone:701-258-8388
Mailing Address - Fax:701-258-8788
Practice Address - Street 1:433 E BISMARCK EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-5801
Practice Address - Country:US
Practice Address - Phone:701-258-0300
Practice Address - Fax:701-258-0301
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND513111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12049OtherBCBS OF ND
ND16602Medicaid
ND16602Medicaid
ND12049OtherBCBS OF ND