Provider Demographics
NPI:1043644131
Name:QUIGLEY, TONNETTA LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:TONNETTA
Middle Name:LYNN
Last Name:QUIGLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 HILL RD N
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-9346
Mailing Address - Country:US
Mailing Address - Phone:614-833-0880
Mailing Address - Fax:614-833-6767
Practice Address - Street 1:641 HILL RD N
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-9346
Practice Address - Country:US
Practice Address - Phone:614-833-0880
Practice Address - Fax:614-833-6767
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-130487207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine