Provider Demographics
NPI:1750511333
Name:SAXON, TIMOTHY SCOTT (DME SUPPLIER)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:SCOTT
Last Name:SAXON
Suffix:
Gender:M
Credentials:DME SUPPLIER
Other - Prefix:
Other - First Name:TIMOTHY
Other - Middle Name:SCOTT
Other - Last Name:SAXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DME SUPPLIER
Mailing Address - Street 1:13221 GOLF RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34669
Mailing Address - Country:US
Mailing Address - Phone:727-207-0093
Mailing Address - Fax:
Practice Address - Street 1:13221 GOLF RIDGE PL
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34669-2461
Practice Address - Country:US
Practice Address - Phone:727-207-0093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255-431-006332B00000X
NY255431006332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies