Provider Demographics
NPI:1902028095
Name:BOYNTON, TIMOTHY E (DC)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:E
Last Name:BOYNTON
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 1:9465 E IRONWOOD SQ DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4579
Mailing Address - Country:US
Mailing Address - Phone:480-860-1093
Mailing Address - Fax:480-860-4664
Practice Address - Street 1:9465 E IRONWOOD SQ DR
Practice Address - Street 2:SUITE 105
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4579
Practice Address - Country:US
Practice Address - Phone:480-860-1093
Practice Address - Fax:480-860-4664
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3695111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T41428Medicare UPIN