Healthcare Provider Details

I. General information

NPI: 1336702448
Provider Name (Legal Business Name): JULIE TOMKINS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2019
Last Update Date: 04/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BEHAVIORAL HEALTH PAVILION 2800 E AJO WAY
TUCSON AZ
85713
US

IV. Provider business mailing address

BEHAVIORAL HEALTH PAVILION 2800 E AJO WAY
TUCSON AZ
85713
US

V. Phone/Fax

Practice location:
  • Phone: 520-874-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR77346
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: