MEDICARE: MICHAEL S TORNWALL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	35066867T	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000195026	OTHER	OH	ANTHEM

General Provider Information

NPI Number	:	1285638957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL S TORNWALL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 228
Second Line	:
City	:	LOGAN
State	:	OH
Zip	:	43138-0228
Country	:	US
Telephone Number	:	740-385-7564
Fax Number	:	740-385-7566

Provider Business Practice Location Address
First Line	:	601 STATE ROUTE 664 N
Second Line	:
City	:	LOGAN
State	:	OH
Zip	:	43138-8541
Country	:	US
Telephone Number	:	740-380-8140
Fax Number	:	740-380-8510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	08/20/2025

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Directions to “ MICHAEL S TORNWALL M.D.” Practice Location

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