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NPI Code Detail

MEDICARE: JAMES TOMER LCSW

MEDICARE: JAMES TOMER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker0666KY

General Provider Information

NPI Number : 1073551974
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES TOMER LCSW
Provider Business Mailing Address
First Line : 1100 WALNUT ST
Second Line :
City : OWENSBORO
State : KY
Zip : 42301-2956
Country : US
Telephone Number : 270-689-6500
Fax Number :
Provider Business Practice Location Address
First Line : 1100 WALNUT ST
Second Line :
City : OWENSBORO
State : KY
Zip : 42301-2956
Country : US
Telephone Number : 270-689-6500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2006
Last Update Date : 08/28/2007

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