Provider Demographics
NPI:1538407846
Name:ROCKLEIN, TIMOTHY SCOTT (PA-C)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:SCOTT
Last Name:ROCKLEIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2070
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37320-2070
Mailing Address - Country:US
Mailing Address - Phone:423-339-9581
Mailing Address - Fax:
Practice Address - Street 1:11416 GRIGSBY CHAPEL RD STE 104
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1649
Practice Address - Country:US
Practice Address - Phone:865-218-2100
Practice Address - Fax:865-218-2101
Is Sole Proprietor?:No
Enumeration Date:2013-01-21
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9107054363AS0400X
FLPA9107054363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical