Individual
JOSHUA ASHER TIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BHRS
Contact information
Practice address
1213 E. JACKSON ST, HUGO, OK 74743
(580) 326-7400
Mailing address
PO BOX 1063, HUGO, OK 74743
(580) 372-0548
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200049040
—
OK
Enumeration date
05/02/2011
Last updated
05/02/2011
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