Provider Demographics
NPI:1801893102
Name:TINSMAN, THOMAS DEAN (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:DEAN
Last Name:TINSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 11137
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72917-1137
Mailing Address - Country:US
Mailing Address - Phone:479-452-6362
Mailing Address - Fax:479-484-5652
Practice Address - Street 1:7320 ROGERS AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4166
Practice Address - Country:US
Practice Address - Phone:479-452-6362
Practice Address - Fax:479-484-5652
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARR2844207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARD75035Medicare UPIN
AR55340Medicare ID - Type Unspecified