MEDICARE: DR. DEVIN KENDRICK TIGHE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	MD.026540	LA
2	2085R0202X	Diagnostic Radiology Physician	0101273090	VA
3	2085R0202X	Diagnostic Radiology Physician	2021-02571	NC

General Provider Information

NPI Number	:	1306021407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEVIN KENDRICK TIGHE M.D.

Provider Business Mailing Address
First Line	:	5220 GREENS DAIRY RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-4612
Country	:	US
Telephone Number	:	919-781-1437
Fax Number	:

Provider Business Practice Location Address
First Line	:	3704 NORTH BLVD STE 1
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-3658
Country	:	US
Telephone Number	:	318-442-8399
Fax Number	:	318-448-9897

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2008
Last Update Date	:	10/07/2024

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