Provider Demographics
NPI:1679509475
Name:TOMLINSON, RUTH ANNE SMREKAR (MD)
Entity Type:Individual
Prefix:
First Name:RUTH ANNE
Middle Name:SMREKAR
Last Name:TOMLINSON
Suffix:
Gender:F
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 4755
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:WY
Mailing Address - Zip Code:83001-4755
Mailing Address - Country:US
Mailing Address - Phone:307-203-5035
Mailing Address - Fax:949-655-6058
Practice Address - Street 1:5237 HHR RANCH RD STE 1
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:WY
Practice Address - Zip Code:83014-9220
Practice Address - Country:US
Practice Address - Phone:307-699-0932
Practice Address - Fax:949-655-6058
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA54041207P00000X
WY7622A2080H0002X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG54041OtherSOUTH CAROLINA MEDICAID
GA565734917AMedicaid
GA93BBGMBMedicare ID - Type Unspecified