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General NPI Number Information
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NPI Number | 1982642443
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Entity Type | Individual
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Provider Name | JANICE KELLY TOMBERLIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 1612 HOSPITAL PKWY
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City | BEDFORD
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State | TX
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Zip | 76022-6913
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Country | US
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Telephone | 817-685-4700
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Fax | 817-685-4595
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Provider Business Mailing Address
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Address Line | PO BOX 911230
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City | DALLAS
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State | TX
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Zip | 75391-1230
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Country | US
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Telephone | 972-997-8000
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Fax | 972-437-9605
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | H2839
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License Number State | TX
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