Provider Demographics
NPI:1144211327
Name:VONLUHRTE, TOMMY (DO)
Entity Type:Individual
Prefix:
First Name:TOMMY
Middle Name:
Last Name:VONLUHRTE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 75 BOX 443
Mailing Address - Street 2:
Mailing Address - City:VANCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41179-9306
Mailing Address - Country:US
Mailing Address - Phone:606-796-2511
Mailing Address - Fax:606-796-2511
Practice Address - Street 1:HC 75 BOX 443
Practice Address - Street 2:
Practice Address - City:VANCEBURG
Practice Address - State:KY
Practice Address - Zip Code:41179-9306
Practice Address - Country:US
Practice Address - Phone:606-796-2511
Practice Address - Fax:606-796-2511
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY02168207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
5304OtherCHA
KY64021686Medicaid
000000077536OtherANTHEM
1464501Medicare ID - Type Unspecified
C7848Medicare UPIN