Individual
TIMOTHY S WAKEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
5295 ADMIRALS LNDG, LANCASTER, SC 29720-6325
(715) 762-2950
Mailing address
500 BIRCH ST, PARK FALLS, WI 54552-1415
(715) 762-2950
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2521-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27443
SECURITY HEALTH PLAN
—
01
—
350023255
RAILROAD MEDICARE
WI
05
—
38847300
—
WI
01
—
38987800
MEDICAID GROUP
WI
01
—
CI2400
RAILROAD MEDICARE GROUP
WI
Enumeration date
09/24/2006
Last updated
08/05/2025
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