Provider Demographics
NPI:1245213818
Name:TOMPKINS, ALLAN L (MD,)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:L
Last Name:TOMPKINS
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 1:150 S EAST AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-2412
Mailing Address - Country:US
Mailing Address - Phone:517-782-7161
Mailing Address - Fax:517-787-8335
Practice Address - Street 1:150 S EAST AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2412
Practice Address - Country:US
Practice Address - Phone:517-782-7161
Practice Address - Fax:517-787-8335
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI37008207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0380018OtherBCBSM
MI1433447Medicaid
MI1433447Medicaid
MID72725Medicare UPIN