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NPI Code Detail

MEDICARE: R C TOMMEY MD

MEDICARE: R C TOMMEY MD
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
1208600000XSurgery PhysicianC5246AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669467361
Entity Type Code : Individual
Provider Name (Legal Business Name) : R C TOMMEY MD
Provider Business Mailing Address
First Line : 704 W GROVE ST
Second Line : SUITE 1
City : EL DORADO
State : AR
Zip : 71730-4416
Country : US
Telephone Number : 870-875-5580
Fax Number : 870-875-5584
Provider Business Practice Location Address
First Line : 704 W GROVE ST
Second Line : SUITE 1
City : EL DORADO
State : AR
Zip : 71730-4416
Country : US
Telephone Number : 870-875-5580
Fax Number : 870-875-5584
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2005
Last Update Date : 08/03/2011

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Directions to “ R C TOMMEY MD” Practice Location

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