Provider Demographics
NPI:1760438642
Name:TONKIN, DAVID M (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:TONKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4514E CROMWELL ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-2551
Mailing Address - Country:US
Mailing Address - Phone:417-553-1080
Mailing Address - Fax:888-472-5145
Practice Address - Street 1:1230 E KINGSLEY ST STE CD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-7211
Practice Address - Country:US
Practice Address - Phone:417-888-0167
Practice Address - Fax:417-888-0189
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2023-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2007017247207L00000X, 207LA0401X, 208VP0014X
NV15564207L00000X, 207LP2900X, 207LA0401X, 208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1760438642Medicaid
MO500025928Medicaid
AR176075001Medicaid
MO1760438642Medicaid
AR176075001Medicaid