Provider Demographics
NPI:1558769968
Name:TORNIK FAMILY MEDICINE
Entity Type:Organization
Organization Name:TORNIK FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:CMRS
Authorized Official - Phone:614-864-9560
Mailing Address - Street 1:209 N CHILLICOTHE ST
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43064-1045
Mailing Address - Country:US
Mailing Address - Phone:614-873-6700
Mailing Address - Fax:614-873-6790
Practice Address - Street 1:209 N CHILLICOTHE ST
Practice Address - Street 2:
Practice Address - City:PLAIN CITY
Practice Address - State:OH
Practice Address - Zip Code:43064-1045
Practice Address - Country:US
Practice Address - Phone:614-873-6700
Practice Address - Fax:614-873-6790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty