Provider Demographics
NPI:1982608741
Name:TINKER, DAVID P (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:P
Last Name:TINKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 ASSOCIATES DR
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-2201
Mailing Address - Country:US
Mailing Address - Phone:563-584-4100
Mailing Address - Fax:563-584-4110
Practice Address - Street 1:911 CARTER ST NW
Practice Address - Street 2:
Practice Address - City:ELKADER
Practice Address - State:IA
Practice Address - Zip Code:52043-9016
Practice Address - Country:US
Practice Address - Phone:563-245-1717
Practice Address - Fax:563-245-2066
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA3180207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G93709Medicare UPIN
IAI14447Medicare ID - Type Unspecified