| Doctor Name: | DR. TIMOTHY WATERS |
| NPI Number: | 1083813885 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | |
| Business Practice Address: | Bldg 301 Andrews Ave Fort Rucker, AL - 363620001 |
| Business Phone Number: | 9154902307 |
| Business Fax Number: | 9154902307 |
| Mailing Address: | Bldg 301 Andrews Ave, FORT RUCKER |
| State: | AL |
| Postal Code: | 363620001 |
| Phone Number: | 9154902307 |
| Fax Number: | 9154902307 |
| NPI Enumeration Date: | 07/12/2007 |
| NPI Last Update Date: | 12/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171000000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Military Health Care Provider |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |