Provider Demographics
NPI:1033176425
Name:COFFMAN, TOMMY MILLS (MD)
Entity Type:Individual
Prefix:DR
First Name:TOMMY
Middle Name:MILLS
Last Name:COFFMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2889 10TH AVE N
Mailing Address - Street 2:STE 306
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-3045
Mailing Address - Country:US
Mailing Address - Phone:561-227-3101
Mailing Address - Fax:561-227-3182
Practice Address - Street 1:2889 10TH AVE N
Practice Address - Street 2:STE 306
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-3045
Practice Address - Country:US
Practice Address - Phone:561-227-3101
Practice Address - Fax:561-227-3182
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2016-03-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME23499207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL036043100Medicaid
FL036043100Medicaid
FL50620ZMedicare PIN
FL50620YMedicare PIN