Provider Demographics
NPI:1265491203
Name:TOMLINSON, WILLIAM V (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:V
Last Name:TOMLINSON
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:PO BOX 63428
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28263-3428
Mailing Address - Country:US
Mailing Address - Phone:864-512-4600
Mailing Address - Fax:864-512-4621
Practice Address - Street 1:2000 E GREENVILLE ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1580
Practice Address - Country:US
Practice Address - Phone:864-512-4600
Practice Address - Fax:864-512-4621
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC111362085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCS296510Medicaid
SCB92331Medicare UPIN
SCS296510Medicaid