Provider Demographics
NPI:1427181379
Name:H EVANGELINE TOMLINSON MD PC
Entity Type:Organization
Organization Name:H EVANGELINE TOMLINSON MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:H
Authorized Official - Middle Name:EVANGELINE
Authorized Official - Last Name:TOMLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-567-6249
Mailing Address - Street 1:4921 SEMINARY ROAD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1803
Mailing Address - Country:US
Mailing Address - Phone:703-567-6249
Mailing Address - Fax:703-567-4245
Practice Address - Street 1:4921 SEMINARY ROAD
Practice Address - Street 2:SUITE 107
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1803
Practice Address - Country:US
Practice Address - Phone:703-567-6249
Practice Address - Fax:703-567-4245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101027630207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC6709OtherBCBS
VA200242OtherBCBS
AT7237856OtherDEA
0408426Medicare ID - Type Unspecified
B94514Medicare UPIN