Provider Demographics
NPI:1750574554
Name:TOMLIN, MERODIE (RPT)
Entity type:Individual
Prefix:
First Name:MERODIE
Middle Name:
Last Name:TOMLIN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W OXMOOR RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6329
Mailing Address - Country:US
Mailing Address - Phone:205-313-2800
Mailing Address - Fax:205-313-2801
Practice Address - Street 1:100 W OXMOOR RD
Practice Address - Street 2:SUITE 180
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6329
Practice Address - Country:US
Practice Address - Phone:205-313-2800
Practice Address - Fax:205-313-2801
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH655225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-42214OtherBCBS
AL515-42198OtherBCBS
AL515-42197OtherBCBS