Healthcare Provider Details

I. General information

NPI: 1831737063
Provider Name (Legal Business Name): DAVID TOMPKINS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2019
Last Update Date: 12/18/2019
Certification Date: 12/18/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 VICTORIA ST
PITTSBURGH PA
15213-2543
US

IV. Provider business mailing address

130 WHITE OAK DR
BUTLER PA
16001-3454
US

V. Phone/Fax

Practice location:
  • Phone: 888-747-0794
  • Fax:
Mailing address:
  • Phone: 724-504-4417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN685197
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: