Individual
DR. JEREMY B TONKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 CLEARFIELD AVE, VIRGINIA BEACH, VA 23462-1815
(757) 457-5100
(757) 819-7762
Mailing address
2041 GEORGIA NW AVE, 4TH FLOOR 4C02, WASHINGTON, DC 20060-0001
(202) 865-1314
(202) 865-1647
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
0101243692
VA
208800000X
Urology Physician
23542
OK
208800000X
Urology Physician
Primary
MD048691
DC
2088P0231X
Pediatric Urology Physician
43980
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201006720
—
IN
01
—
50030679
PASSPORT HEALTH PLAN
KY
05
—
7100140700
—
KY
Enumeration date
01/10/2007
Last updated
02/10/2021
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