MEDICARE: RODERICK J. TOMPKINS JR. M.D.

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	208600000X	Surgery Physician	32875	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306892559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODERICK J. TOMPKINS JR. M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2379
Second Line	:
City	:	ASHLAND
State	:	KY
Zip	:	41105-2379
Country	:	US
Telephone Number	:	606-408-6200
Fax Number	:	606-408-6612

Provider Business Practice Location Address
First Line	:	613 23RD ST
Second Line	:	SUITE 440
City	:	ASHLAND
State	:	KY
Zip	:	41101-2878
Country	:	US
Telephone Number	:	606-329-2888
Fax Number	:	606-329-2890

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	05/22/2019

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