Provider Demographics
NPI:1952391559
Name:HARRELSON, TIMOTHY G JR (PA)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:G
Last Name:HARRELSON
Suffix:JR
Gender:M
Credentials:PA
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Mailing Address - Street 1:3909 ARCTIC BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-5769
Mailing Address - Country:US
Mailing Address - Phone:907-644-8446
Mailing Address - Fax:907-644-8448
Practice Address - Street 1:3909 ARCTIC BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503
Practice Address - Country:US
Practice Address - Phone:907-644-8446
Practice Address - Fax:907-644-8448
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2019-02-07
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant