Healthcare Provider Details

I. General information

NPI: 1699762229
Provider Name (Legal Business Name): THOMAS L POMMERING DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 02/18/2022
Certification Date: 02/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

584 COUNTY LINE RD W
WESTERVILLE OH
43082-7295
US

IV. Provider business mailing address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

V. Phone/Fax

Practice location:
  • Phone: 614-355-6000
  • Fax:
Mailing address:
  • Phone: 614-355-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34005529
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number34005529
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code2080S0010X
TaxonomyPediatric Sports Medicine Physician
License Number34005529
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: