Individual
TIMOTHY CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
900 PEELER ST, KALAMAZOO, MI 49008-2300
(269) 342-7827
Mailing address
900 PEELER ST, KALAMAZOO, MI 49008-2300
(269) 342-7827
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601004857
MI
363AM0700X
Medical Physician Assistant
Primary
5601004857
MI
Other
Enumeration date
09/20/2006
Last updated
02/17/2025
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