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General NPI Number Information
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NPI Number | 1669477170
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Entity Type | Individual
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Provider Name | ROGER W TINSLEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 17 E GENESEE ST STE 101
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City | AUBURN
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State | NY
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Zip | 13021-4040
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Country | US
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Telephone | 315-255-3331
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Fax | 315-255-6145
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Provider Business Mailing Address
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Address Line | 17 E GENESEE ST STE 101
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City | AUBURN
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State | NY
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Zip | 13021-4040
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Country | US
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Telephone | 315-255-3331
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Fax | 315-255-6145
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 127128
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License Number State | NY
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