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General NPI Number Information
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NPI Number | 1922081322
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Entity Type | Individual
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Provider Name | CLARK CURTIS TOMLINSON CRNA
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Gender | Male
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 05/06/2008
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Provider Practice Location Address
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Address Line | 364 WHITE OAK ST RANDOLPH HOSPITAL
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City | ASHEBORO
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State | NC
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Zip | 27203-5434
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Country | US
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Telephone | 336-683-5284
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Fax | 336-683-5279
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Provider Business Mailing Address
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Address Line | PO BOX 4174 ANESTHESIA OF RANDOLPH COUNTY PA
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City | ASHEBORO
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State | NC
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Zip | 27204-4174
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Country | US
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Telephone | 336-683-5284
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Fax | 336-683-5279
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 164569
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License Number State | NC
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