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Organization

TINSLEY MEDICAL CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. AUSTIN R TINSLEY MD (OWNER)
(573) 686-1144
Entity
Organization

Contact information

Practice address
2400 LUCY LEE PKWY, POPLAR BLUFF, MO 63901-2429
(573) 686-1144
(573) 686-3312
Mailing address
2400 LUCY LEE PKWY, POPLAR BLUFF, MO 63901-2429
(573) 686-1144
(573) 686-3312

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34610
MO
261QR1300X
Rural Health Clinic/Center
MO
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3941210001
DME NUMBER
MO
05
5076174600
MO
Enumeration date
04/05/2006
Last updated
11/02/2011
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