Provider Demographics
NPI:1285086488
Name:TINGLE, MATTHEW KENNETH (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:KENNETH
Last Name:TINGLE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 INTERSTATE NORTH CIR SE STE 500
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2296
Mailing Address - Country:US
Mailing Address - Phone:770-953-6929
Mailing Address - Fax:
Practice Address - Street 1:465 N BELAIR RD STE 3C
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3191
Practice Address - Country:US
Practice Address - Phone:706-620-3635
Practice Address - Fax:706-620-3623
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA97216207X00000X
CAA177953207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery