MEDICARE: DR. DAVID J TOMLINSON 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	207L00000X	Anesthesiology Physician	24055	SC
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	7591A	WY
3	207L00000X	Anesthesiology Physician	7591A	WY

General Provider Information

NPI Number	:	1851350292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID J TOMLINSON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 13099
Second Line	:
City	:	JACKSON
State	:	WY
Zip	:	83002-3099
Country	:	US
Telephone Number	:	307-739-7218
Fax Number	:	307-739-7446

Provider Business Practice Location Address
First Line	:	625 E BROADWAY
Second Line	:
City	:	JACKSON
State	:	WY
Zip	:	83002
Country	:	US
Telephone Number	:	307-739-7218
Fax Number	:	307-739-7446

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	02/19/2021

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