Healthcare Provider Details

I. General information

NPI: 1275605206
Provider Name (Legal Business Name): SHARON MARIE TOMASKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 11/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 W GROVE ST STE 201
EL DORADO AR
71730-4425
US

IV. Provider business mailing address

620 W GROVE ST STE 201
EL DORADO AR
71730-4425
US

V. Phone/Fax

Practice location:
  • Phone: 870-864-3352
  • Fax: 870-864-3255
Mailing address:
  • Phone: 870-864-3352
  • Fax: 870-864-3255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number39311
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number39311
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number35.120287
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number35.120287
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: