Provider Demographics
NPI:1083701452
Name:TINGLE, WILLIAM JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JAMES
Last Name:TINGLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:1 SOUTH SCHOOL AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237
Practice Address - Country:US
Practice Address - Phone:941-309-7000
Practice Address - Fax:941-309-7007
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2017-04-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME59349208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376030800Medicaid
340009780OtherMEDICARE RAILROAD
FL4605729OtherAETNA
FL1193488OtherWELLCARE
FLP104324OtherFREEDOM HEALTH
FLP512083OtherOPTIMUM
FL208525OtherAVMED
FLP01807653OtherCLEAR HEALTH
FLP01078296OtherRAILROAD MEDICARE
FLQMP000005228656OtherMOLINA
FL1484132OtherCIGNA
FL165719OtherUNIVERSAL
FLP01078296OtherRAILROAD MEDICARE
FL1484132OtherCIGNA
FLQMP000005228656OtherMOLINA
F77285Medicare UPIN