| Doctor Name: | TIMOTHY L. NISLEY |
| NPI Number: | 1558616623 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RT(R) |
| License Number: | 483666 |
| Business Practice Address: | 622 County Road 597 Hanceville, AL - 350777361 |
| Business Phone Number: | 2562754410 |
| Business Fax Number: | |
| Mailing Address: | 622 County Road 597, HANCEVILLE |
| State: | AL |
| Postal Code: | 350777361 |
| Phone Number: | 2562754410 |
| Fax Number: | |
| NPI Enumeration Date: | 07/16/2012 |
| NPI Last Update Date: | 07/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471C3402X |
| License Number: | 483666 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Radiography |
| Taxonomy Definition: | |