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General NPI Number Information
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NPI Number | 1336177864
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Entity Type | Individual
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Provider Name | JASON C TOMPKINS MD
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 31 N SAINT JOSEPH AVE
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City | NILES
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State | MI
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Zip | 49120-2207
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Country | US
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Telephone | 269-687-5510
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Fax | 269-684-0189
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Provider Business Mailing Address
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Address Line | 1000 N OAK AVE
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City | MARSHFIELD
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State | WI
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Zip | 54449-5703
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Country | US
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Telephone | 715-387-5511
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 4301083277
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 64047
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License Number State | WI
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