Healthcare Provider Details

I. General information

NPI: 1598298077
Provider Name (Legal Business Name): JOHN MARK TOHLEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 FM 2181 STE 300
CORINTH TX
76210
US

IV. Provider business mailing address

3001 FM 2181 STE 300
CORINTH TX
76210
US

V. Phone/Fax

Practice location:
  • Phone: 940-497-4900
  • Fax: 940-497-4901
Mailing address:
  • Phone: 940-497-4900
  • Fax: 940-497-4901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberS4244
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: