Unknown Individual – Family Medicine Physician, NPI 1033109905
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
4293, Kinsey Drive, Tyler, Smith County, Texas, 75703, United States
TYLER, TX 757031004
Phone: (903) 561-6308
Fax: (903) 561-2397
Type: Location
134, Pocono Road, Flint, Columbus, Sharon Township, Franklin County, Ohio, 43235, United States
FLINT, TX 757623835
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 75703)
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