Provider Demographics
NPI:1215030523
Name:TOMLINSON, JAMES HENRY II (PA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:HENRY
Last Name:TOMLINSON
Suffix:II
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:PO BOX 580
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27313-0580
Mailing Address - Country:US
Mailing Address - Phone:336-674-6191
Mailing Address - Fax:336-674-6496
Practice Address - Street 1:1500 NEELLEY RD
Practice Address - Street 2:
Practice Address - City:PLEASANT GARDEN
Practice Address - State:NC
Practice Address - Zip Code:27313-0580
Practice Address - Country:US
Practice Address - Phone:336-674-6191
Practice Address - Fax:336-674-6496
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC100805363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2755023Medicare ID - Type Unspecified
C83647Medicare UPIN