MEDICARE: DR. KEVIN L TOMSIC MD, DC

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	111N00000X	Chiropractor	6343	TX
2	207Q00000X	Family Medicine Physician	N7185	TX
3	207Q00000X	Family Medicine Physician	27342	OK
4	111N00000X	Chiropractor	3522	OK

General Provider Information

NPI Number	:	1659570356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN L TOMSIC MD, DC

Provider Business Mailing Address
First Line	:	627 RUSSELL BLVD
Second Line	:
City	:	NACOGDOCHES
State	:	TX
Zip	:	75965-5855
Country	:	US
Telephone Number	:	936-205-5965
Fax Number	:	936-205-5967

Provider Business Practice Location Address
First Line	:	627 RUSSELL BLVD
Second Line	:
City	:	NACOGDOCHES
State	:	TX
Zip	:	75965-1247
Country	:	US
Telephone Number	:	936-205-5965
Fax Number	:	936-205-5967

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

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	12/10/2025

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