Tanksley, Radford Douglas
Tanksley, Radford Douglas is an individual health care provider with primary practice located at 111 Salem Tpke Suite 7, Norwich CT 06360-6459. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Tanksley, Radford Douglas can be contacted via phone (860) 859-2262.Contact Information
Primary practice address
111 Salem Tpke Suite 7
Norwich CT 06360-6459
Phone: (860) 859-2262
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 030170 | Connecticut |
Profile Details
| NPI number | 1629041728 |
|---|---|
| LBN Legal business name | Tanksley, Radford Douglas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 9th, 2006 |
| Last updated | Aug 18th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629041728 | NPPES |
| Connecticut | Other | P00332772 | RAILROAD |
| Connecticut | Other | 010030170CT02 | RAILROAD |
| Connecticut | MEDICAID | 030170 | RAILROAD |
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