Provider Demographics
NPI:1710969530
Name:TARWATER, DONALD E (DO)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:E
Last Name:TARWATER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 N WALDRON ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1131
Mailing Address - Country:US
Mailing Address - Phone:620-669-2500
Mailing Address - Fax:
Practice Address - Street 1:2101 N WALDRON ST
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1131
Practice Address - Country:US
Practice Address - Phone:620-669-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-20128207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100234450BMedicaid
KS100234450AMedicaid
KS100234450BMedicaid
KS100234450AMedicaid
KS003768030Medicare PIN