Provider Demographics
NPI:1689154726
Name:NEUZIL, TIMOTHY EDWARD (PA-C)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:EDWARD
Last Name:NEUZIL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:3325 S LOVERS LN APT E
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-9836
Mailing Address - Country:US
Mailing Address - Phone:319-330-3499
Mailing Address - Fax:
Practice Address - Street 1:3325 S LOVERS LN APT E
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93292-9836
Practice Address - Country:US
Practice Address - Phone:319-356-8851
Practice Address - Fax:319-330-3499
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2022-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA092671363A00000X
CA60432363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant