Healthcare Provider Details

I. General information

NPI: 1922178755
Provider Name (Legal Business Name): DRS TOMLIN & GOSSMANN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 SPRING ST
JEFFERSONVILLE IN
47130
US

IV. Provider business mailing address

1220 SPRING ST
JEFFERSONVILLE IN
47130
US

V. Phone/Fax

Practice location:
  • Phone: 812-282-8494
  • Fax: 812-288-4481
Mailing address:
  • Phone: 812-282-8494
  • Fax: 812-288-4481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BRENT M WALZ
Title or Position: MD
Credential: MD
Phone: 812-282-8494