UDOM TINSATUL, MD - NPI 1063525103 - General Practice in Ashley, ND

Q: What is Ashley Clinic P C Tinsa's NPI number?

The NPI number for Ashley Clinic P C Tinsa is 1063525103. It was assigned to this organization in the NPPES registry on August 15, 2006. The provider is doing business as Udom Tinsatul, MD.

Q: What is Ashley Clinic P C Tinsa's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

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About Udom Tinsatul, Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UDOM TINSATUL, MD (NPI 1063525103) is a healthcare organization registered as a general practice in Ashley, North Dakota and active in the NPI registry since August 2006. The organization lists Udom Tinsatul, President, as its authorized official.

NPPES Registry Identity

NPI1063525103

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameASHLEY CLINIC P C TINSA

Location Address612 CENTER AVE NAshley, ND 58413-7013

Mailing AddressPo Box 180, 612 Center Ave NAshley, ND 58413-0180 · (701) 288-3431 · Fax (701) 288-3432

Phone(701) 288-3431

Fax(701) 288-3432

Organization SubpartNo

Authorized OfficialUdom TinsatulPresident · (701) 288-3431

Enumeration DateAugust 15, 2006

Last NPPES UpdateMarch 9, 2015

✔ NPI 1063525103 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in ND · 3926

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedSurgeryTaxonomy 208600000X · License 3926 (ND)

612 CENTER AVE N, Ashley, ND 58413

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Other Names 1

Doing Business AsUdom Tinsatul, Md

Other Identifiers 9

Other450389987Champus

Medicaid7775690SD

Other00125001ND · Bcbs Group #

Medicare PINN6318ND

Other=========000ND · Workers Compensation

Medicare UPIND26349

Medicaid10000ND

Medicaid12755ND

Other1714ND · Bcbs Individual #

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CORI LYNN RANDALL FNP-C

Nurse Practitioner (Family)