Provider Demographics
NPI:1952524035
Name:DUGUID, TONYA M (DO)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:M
Last Name:DUGUID
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6920 POINTE INVERNESS WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-7938
Mailing Address - Country:US
Mailing Address - Phone:260-479-3513
Mailing Address - Fax:260-479-3520
Practice Address - Street 1:2235 DUBOIS DR
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-3212
Practice Address - Country:US
Practice Address - Phone:574-371-2625
Practice Address - Fax:260-479-2904
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02003415A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200948640Medicaid
IN200948640Medicaid
IN184640GGMedicare PIN
INP00757151OtherRAILROAD MEDICARE - OSCEOLA
IN200948640Medicaid
INM400020680Medicare PIN
IN250820GMedicare PIN