Provider Demographics
NPI:1508935446
Name:TINSLEY, ALLEN LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:LEE
Last Name:TINSLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:AR
Mailing Address - Zip Code:72006-0497
Mailing Address - Country:US
Mailing Address - Phone:870-347-2534
Mailing Address - Fax:
Practice Address - Street 1:211 S 8TH ST
Practice Address - Street 2:
Practice Address - City:MAYFIELD
Practice Address - State:KY
Practice Address - Zip Code:42066-2203
Practice Address - Country:US
Practice Address - Phone:708-047-7102
Practice Address - Fax:270-804-7722
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY25179207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1508935446OtherBCBS
KY64251796Medicaid
KYP400017683Medicare PIN
E39222Medicare UPIN