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General NPI Number Information
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NPI Number | 1033430871
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Entity Type | Organization
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Legal Business Name | THOMAS A. TOMLIN M.D. PA
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Dates
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Enumeration Date | 06/16/2010
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Last Update Date | 06/16/2010
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Provider Practice Location Address
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Address Line | 1100 SAWGRASS VILLAGE DR SUITE 100
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City | PONTE VEDRA BEACH
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State | FL
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Zip | 32082-5048
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Country | US
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Telephone | 904-285-9355
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Fax | 904-285-7442
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Provider Business Mailing Address
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Address Line | 3948 3RD ST S # 384
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-5847
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Country | US
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Telephone | 904-285-9355
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Fax | 904-285-7442
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MR. THOMAS A. TOMLIN
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Credential | M.D.
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Telephone | 904-285-9355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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