Healthcare Provider Details

I. General information

NPI: 1851213037
Provider Name (Legal Business Name): TOMCZYK MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3193 HOWELL MILL RD NW STE 329
ATLANTA GA
30327-2100
US

IV. Provider business mailing address

194 HIATUS CT
RIDGELAND SC
29936-9717
US

V. Phone/Fax

Practice location:
  • Phone: 404-352-4210
  • Fax: 404-352-5868
Mailing address:
  • Phone: 814-440-7321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KENNETH TOMCZYK
Title or Position: OWNER
Credential: DO
Phone: 814-440-7321