Provider Demographics
NPI:1578837860
Name:KILEY K. TIMMONS, D.C., P.A.
Entity Type:Organization
Organization Name:KILEY K. TIMMONS, D.C., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KILEY
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:TIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:806-637-0806
Mailing Address - Street 1:1003 LUBBOCK RD
Mailing Address - Street 2:
Mailing Address - City:BROWNFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:79316-2731
Mailing Address - Country:US
Mailing Address - Phone:806-637-0806
Mailing Address - Fax:
Practice Address - Street 1:1003 LUBBOCK RD
Practice Address - Street 2:
Practice Address - City:BROWNFIELD
Practice Address - State:TX
Practice Address - Zip Code:79316-2731
Practice Address - Country:US
Practice Address - Phone:806-637-0806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-04
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11421111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty