Healthcare Provider Details

I. General information

NPI: 1821067471
Provider Name (Legal Business Name): JOEL E TOMPKINS CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 04/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7007 POWERS BLVD
PARMA OH
44129-5437
US

IV. Provider business mailing address

PO BOX 235022
MONTGOMERY AL
36123-5022
US

V. Phone/Fax

Practice location:
  • Phone: 440-743-4000
  • Fax:
Mailing address:
  • Phone: 334-396-6930
  • Fax: 334-396-6929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN355869L
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: