Provider Demographics
NPI:1134415672
Name:TIMMS, BRIAN M (MSW)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:M
Last Name:TIMMS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3507 E ADMIRAL PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74115-8211
Mailing Address - Country:US
Mailing Address - Phone:918-834-4194
Mailing Address - Fax:918-834-4189
Practice Address - Street 1:3507 E ADMIRAL PL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74115-8211
Practice Address - Country:US
Practice Address - Phone:918-834-4194
Practice Address - Fax:918-834-4189
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker