MEDICARE: TOMMY VONLUHRTE DO

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
1	207Q00000X	Family Medicine Physician	02168	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	5304	OTHER	CHA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000000077536	OTHER	ANTHEM

General Provider Information

NPI Number	:	1144211327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TOMMY VONLUHRTE DO

Provider Business Mailing Address
First Line	:	HC 75 BOX 443
Second Line	:
City	:	VANCEBURG
State	:	KY
Zip	:	41179-9306
Country	:	US
Telephone Number	:	606-796-2511
Fax Number	:	606-796-2511

Provider Business Practice Location Address
First Line	:	HC 75 BOX 443
Second Line	:
City	:	VANCEBURG
State	:	KY
Zip	:	41179-9306
Country	:	US
Telephone Number	:	606-796-2511
Fax Number	:	606-796-2511

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	07/08/2007

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