Provider Demographics
NPI:1831485317
Name:TOMSEN, NICHOLAS ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:ANDREW
Last Name:TOMSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1126 S CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-2913
Mailing Address - Country:US
Mailing Address - Phone:316-350-8008
Mailing Address - Fax:316-350-8020
Practice Address - Street 1:1126 S CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-2913
Practice Address - Country:US
Practice Address - Phone:316-350-8008
Practice Address - Fax:316-350-8020
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2018-09-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS7701207Q00000X
KS04-35923207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine