Provider Demographics
NPI:1447375209
Name:MARKUS, TIMOTHY STEVEN (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:STEVEN
Last Name:MARKUS
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 CANTERBURY DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2341
Mailing Address - Country:US
Mailing Address - Phone:785-621-4570
Mailing Address - Fax:785-621-4571
Practice Address - Street 1:2209 CANTERBURY DR
Practice Address - Street 2:SUITE B
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2341
Practice Address - Country:US
Practice Address - Phone:785-621-4570
Practice Address - Fax:785-621-4571
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-02327225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200421610AMedicaid
KS200421610AMedicaid