Healthcare Provider Details

I. General information

NPI: 1801846001
Provider Name (Legal Business Name): MICHAEL J TINGEY MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 02/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 E SOUTHERN AVE SUITE B2
TEMPE AZ
85282-7610
US

IV. Provider business mailing address

2600 E SOUTHERN AVE SUITE B2
TEMPE AZ
85282-7610
US

V. Phone/Fax

Practice location:
  • Phone: 480-730-5100
  • Fax: 480-730-6613
Mailing address:
  • Phone: 480-730-5100
  • Fax: 480-730-6613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL J TINGEY
Title or Position: PRESIDENT CEO
Credential: MD
Phone: 480-730-5100