Provider Demographics
NPI:1639559537
Name:TINDLE, DON-THOMAS (IDEPENDENT DUTY CORP)
Entity Type:Individual
Prefix:
First Name:DON-THOMAS
Middle Name:
Last Name:TINDLE
Suffix:
Gender:M
Credentials:IDEPENDENT DUTY CORP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 CHELA AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23503-1006
Mailing Address - Country:US
Mailing Address - Phone:480-544-7920
Mailing Address - Fax:480-544-7920
Practice Address - Street 1:1501 CHELA AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23503-1006
Practice Address - Country:US
Practice Address - Phone:480-544-7920
Practice Address - Fax:480-544-7920
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant