Organization Name: | MEDICAL OFFICE LLC |
NPI Number: | 1629392394 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JERRY A TOMLINSON (MD) |
Mailing Address: | 115 E 5th St Tuscumbia |
State: | AL US |
Postal Code: | 356742409 |
Phone Number: | 2563140025 |
Fax Number: | 2563140026 |
NPI Enumeration Date: | 03/24/2010 |
NPI Last Update Date: | 04/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 9595 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |