Provider Demographics
NPI:1306955422
Name:TIGAR, TOMMY R (MD)
Entity type:Individual
Prefix:DR
First Name:TOMMY
Middle Name:R
Last Name:TIGAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10500 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4402
Mailing Address - Country:US
Mailing Address - Phone:513-865-2246
Mailing Address - Fax:513-865-5596
Practice Address - Street 1:10500 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-4402
Practice Address - Country:US
Practice Address - Phone:513-865-2246
Practice Address - Fax:513-865-5596
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074055T174400000X
OH35.074055207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2149099Medicaid
OH0878904Medicare PIN
OH2149099Medicaid
OH110220428Medicare PIN
OH0878905Medicare PIN
OHG94967Medicare UPIN
OH0878902Medicare PIN
OH7285661Medicare PIN