Provider Demographics
NPI:1164458659
Name:TINTNER, RON (MD)
Entity Type:Individual
Prefix:
First Name:RON
Middle Name:
Last Name:TINTNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3 MARYLAND FARMS STE 200
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5005
Mailing Address - Country:US
Mailing Address - Phone:615-345-5400
Mailing Address - Fax:888-468-6603
Practice Address - Street 1:61 THUNDERCLOUD RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87506-0121
Practice Address - Country:US
Practice Address - Phone:615-345-5400
Practice Address - Fax:888-468-6603
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2024-02-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXF83432084N0400X
NMMD2019-07292084N0400X
GA786952084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102070305Medicaid
TX8S5370OtherBLUE CROSS BLUE SHIELD
FLME133158OtherFL STATE LICENSE
TX8G4372Medicare PIN