Healthcare Provider Details

I. General information

NPI: 1851927172
Provider Name (Legal Business Name): KATHRYN TINDLE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2020
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 BOATNER RD
EGLIN AIR FORCE BASE FL
32542
US

IV. Provider business mailing address

306 BOATNER RD
EGLIN AIR FORCE BASE FL
32542
US

V. Phone/Fax

Practice location:
  • Phone: 850-883-8600
  • Fax:
Mailing address:
  • Phone: 850-883-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS18639
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: