Healthcare Provider Details

I. General information

NPI: 1952524035
Provider Name (Legal Business Name): TONYA M DUGUID DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 12/15/2021
Certification Date: 12/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2235 DUBOIS DR
WARSAW IN
46580-3212
US

IV. Provider business mailing address

6920 POINTE INVERNESS WAY SUITE 200
FORT WAYNE IN
46804-7938
US

V. Phone/Fax

Practice location:
  • Phone: 574-371-2625
  • Fax: 260-479-2904
Mailing address:
  • Phone: 260-479-3513
  • Fax: 260-479-3520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02003415A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: