Provider Demographics
NPI:1275511370
Name:TOMBERLIN, JOHN CAREY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CAREY
Last Name:TOMBERLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1928
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39818-1928
Mailing Address - Country:US
Mailing Address - Phone:334-684-3655
Mailing Address - Fax:334-684-3312
Practice Address - Street 1:301 ANDREWS AVE
Practice Address - Street 2:LYSTER ARMY HEALTH CLINIC
Practice Address - City:FORT RUCKER
Practice Address - State:AL
Practice Address - Zip Code:36362
Practice Address - Country:US
Practice Address - Phone:334-255-7387
Practice Address - Fax:334-255-7716
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME604382085R0202X
AL109252085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology