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NPI Code Detail

MEDICARE: GREGORY R. TOOTHMAN M.D.

MEDICARE: GREGORY R. TOOTHMAN 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
1207Q00000XFamily Medicine Physician01047543AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000190630OTHERINBCBS PIN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538162920
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY R. TOOTHMAN M.D.
Provider Business Mailing Address
First Line : PO BOX 1510
Second Line :
City : EVANSVILLE
State : IN
Zip : 47706-1510
Country : US
Telephone Number : 812-858-9400
Fax Number : 812-858-9571
Provider Business Practice Location Address
First Line : 4015 GATEWAY BLVD
Second Line :
City : NEWBURGH
State : IN
Zip : 47630-8925
Country : US
Telephone Number : 812-858-9400
Fax Number : 812-858-9571
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 03/12/2013

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