Provider Demographics
NPI:1568800365
Name:TIGNOR, RICHARD FRANKLIN (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:FRANKLIN
Last Name:TIGNOR
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 1:1413 CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3042
Mailing Address - Country:US
Mailing Address - Phone:570-323-1306
Mailing Address - Fax:
Practice Address - Street 1:1413 CAMPBELL ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3042
Practice Address - Country:US
Practice Address - Phone:570-323-1306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028791L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA031-OC-05-03855OtherMCARE REFERENCE