Provider Demographics
NPI:1689939225
Name:TIMER, BRYON
Entity Type:Individual
Prefix:MR
First Name:BRYON
Middle Name:
Last Name:TIMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3433 N. EXT. RD.
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85256-3713
Mailing Address - Country:US
Mailing Address - Phone:480-334-3740
Mailing Address - Fax:
Practice Address - Street 1:7579 E. MAIN STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85215-4562
Practice Address - Country:US
Practice Address - Phone:480-275-7150
Practice Address - Fax:480-275-7415
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker