Individual
DR. THOMAS JOHN TINNESZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
719 DETROIT STREET, DANVILLE, AR 72833
(479) 495-2241
(479) 495-6299
Mailing address
PO BOX 639, DANVILLE, AR 72833-0639
(479) 495-2241
(479) 495-6299
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R-3688
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020035810
RAILROAD MEDICARE
AR
05
—
100018580A
—
OK
05
—
112619001
—
AR
01
—
50830
BLUE CROSS BLUE SHIELD
AR
01
—
710800715
GEHA
AR
Enumeration date
05/18/2006
Last updated
10/30/2012
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