Provider Demographics
NPI:1386748531
Name:RINGENBERG, THOMAS J (DO)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:J
Last Name:RINGENBERG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 ETNA AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:46750
Mailing Address - Country:US
Mailing Address - Phone:260-356-9400
Mailing Address - Fax:260-356-4254
Practice Address - Street 1:941 ETNA AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:IN
Practice Address - Zip Code:46750
Practice Address - Country:US
Practice Address - Phone:260-356-9400
Practice Address - Fax:260-356-4254
Is Sole Proprietor?:No
Enumeration Date:2006-09-09
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02000874207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100138170AMedicaid
IN371260OtherMEDICARE PTAN
IN371260OtherMEDICARE PTAN
IN100138170AMedicaid