Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 30-012784 | OH |
NPI | 1477550952 |
---|---|
Provider Name | Dr. Michael R Tinkler |
First Address | Piqua, OH 45356-1739 |
Second Address | Piqua, OH 45356-1739 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 25/01/2011 |