Provider Demographics
NPI:1447272638
Name:HOWARD, TIMOTHY CLEVE (DC)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:CLEVE
Last Name:HOWARD
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:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30237-0069
Mailing Address - Country:US
Mailing Address - Phone:770-961-5577
Mailing Address - Fax:770-961-1407
Practice Address - Street 1:750 MOUNT ZION RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-3002
Practice Address - Country:US
Practice Address - Phone:770-961-5577
Practice Address - Fax:770-961-1407
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006820111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00219463OtherRAILROAD MEDICARE
GAU89240Medicare UPIN
GA35ZCGRWMedicare ID - Type Unspecified
GAGRP1288Medicare ID - Type UnspecifiedGROUP NUMBER