Provider Demographics
NPI:1922178755
Name:DRS TOMLIN & GOSSMANN INC
Entity Type:Organization
Organization Name:DRS TOMLIN & GOSSMANN INC
Other - Org Name:ORTHOPEDIC SURGEONS PSC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:M
Authorized Official - Last Name:WALZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-282-8494
Mailing Address - Street 1:1220 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130
Mailing Address - Country:US
Mailing Address - Phone:812-282-8494
Mailing Address - Fax:812-288-4481
Practice Address - Street 1:1220 SPRING ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130
Practice Address - Country:US
Practice Address - Phone:812-282-8494
Practice Address - Fax:812-288-4481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1003846700Medicaid
IN122180Medicare PIN
IN0416850001Medicare NSC