Provider Demographics
NPI:1427119478
Name:NIX, TIMOTHY JOSHUA (DC)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JOSHUA
Last Name:NIX
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 1:12150 NE 155TH RD
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:OK
Mailing Address - Zip Code:74563-5124
Mailing Address - Country:US
Mailing Address - Phone:918-448-6054
Mailing Address - Fax:
Practice Address - Street 1:106 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:OK
Practice Address - Zip Code:74563-6506
Practice Address - Country:US
Practice Address - Phone:918-448-6054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4045111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation