Provider Demographics
NPI:1982762126
Name:HAIL, TIMOTHY ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:ALAN
Last Name:HAIL
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 1:619 INDUSTRIAL PARKWAY
Mailing Address - Street 2:SUITE A.
Mailing Address - City:HEATH
Mailing Address - State:OH
Mailing Address - Zip Code:43056-1529
Mailing Address - Country:US
Mailing Address - Phone:740-522-6919
Mailing Address - Fax:740-522-3100
Practice Address - Street 1:619 INDUSTRIAL PARKWAY
Practice Address - Street 2:SUITE A.
Practice Address - City:HEATH
Practice Address - State:OH
Practice Address - Zip Code:43056-1529
Practice Address - Country:US
Practice Address - Phone:740-522-6919
Practice Address - Fax:740-522-3100
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH598111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0311782Medicaid
OH0426871Medicare ID - Type Unspecified
OHT46807Medicare UPIN