Healthcare Provider Details

I. General information

NPI: 1760438642
Provider Name (Legal Business Name): DAVID M TONKIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 10/09/2023
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 E KINGSLEY ST STE CD
SPRINGFIELD MO
65804-7211
US

IV. Provider business mailing address

4514E CROMWELL ST
SPRINGFIELD MO
65802-2551
US

V. Phone/Fax

Practice location:
  • Phone: 417-888-0167
  • Fax: 417-888-0189
Mailing address:
  • Phone: 417-553-1080
  • Fax: 888-472-5145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2007017247
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number15564
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number15564
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number2007017247
License Number StateMO
# 5
Primary TaxonomyN
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number15564
License Number StateNV
# 6
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number15564
License Number StateNV
# 7
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number15564
License Number StateNV
# 8
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number2007017247
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: