Provider Demographics
NPI:1689644510
Name:MILEV, TZONKO V (MD)
Entity Type:Individual
Prefix:
First Name:TZONKO
Middle Name:V
Last Name:MILEV
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 1:1542 MEDICAL PARK CIR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6560
Mailing Address - Country:US
Mailing Address - Phone:662-844-4711
Mailing Address - Fax:662-844-9619
Practice Address - Street 1:1542 MEDICAL PARK CIR
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6560
Practice Address - Country:US
Practice Address - Phone:662-844-4711
Practice Address - Fax:662-844-9619
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS16355207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00120600Medicaid
73000857OtherBLUE CROSS BLUE SHIELD
MS3135095OtherBLUE CROSS BLUE SHIELD
16355OtherSTATE LIC NUMBER
AL009970190Medicaid
73000857OtherBLUE CROSS BLUE SHIELD
MS3135095OtherBLUE CROSS BLUE SHIELD
F61072Medicare UPIN
AL009970190Medicaid
MS00120600Medicaid