Healthcare Provider Details

I. General information

NPI: 1972573723
Provider Name (Legal Business Name): RORY LEWIS TOMPKINS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 02/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 N JESSE JAMES RD SUITE 2
EXCELSIOR SPRINGS MO
64024-1202
US

IV. Provider business mailing address

1006 N JESSE JAMES RD SUITE 2
EXCELSIOR SPRINGS MO
64024-1202
US

V. Phone/Fax

Practice location:
  • Phone: 816-637-0117
  • Fax: 816-637-0814
Mailing address:
  • Phone: 816-637-0117
  • Fax: 816-637-0814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR6H00
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: