Provider Demographics
NPI:1235527417
Name:THOLKING, JOHN HENRY (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:HENRY
Last Name:THOLKING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10064 OLD FARM CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5926
Mailing Address - Country:US
Mailing Address - Phone:513-891-8152
Mailing Address - Fax:
Practice Address - Street 1:10064 OLD FARM CT
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-5926
Practice Address - Country:US
Practice Address - Phone:513-891-8152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-22
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.033624208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics