Healthcare Provider Details

I. General information

NPI: 1164458659
Provider Name (Legal Business Name): RON TINTNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 THUNDERCLOUD RD
SANTA FE NM
87506-0121
US

IV. Provider business mailing address

3 MARYLAND FARMS STE 200
BRENTWOOD TN
37027-5005
US

V. Phone/Fax

Practice location:
  • Phone: 615-345-5400
  • Fax: 888-468-6603
Mailing address:
  • Phone: 615-345-5400
  • Fax: 888-468-6603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberF8343
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD2019-0729
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number78695
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: