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Individual

DR. TIM R TARKENTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
220 SW 26TH AVE, MINERAL WELLS, TX 76067
(940) 328-1261
(940) 325-9696
Mailing address
220 SW 26TH AVE, MINERAL WELLS, TX 76067
(940) 328-1261
(940) 325-9696

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
H2824
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10020986
AMERIGROUP
TX
05
123030201
TX
Enumeration date
10/24/2006
Last updated
05/30/2012
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