Provider Demographics
NPI:1912241050
Name:TOBIN, ROSS MARC (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:MARC
Last Name:TOBIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 YORKSHIRE CIR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-7136
Mailing Address - Country:US
Mailing Address - Phone:615-333-7971
Mailing Address - Fax:
Practice Address - Street 1:346 YORKSHIRE CIR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-7136
Practice Address - Country:US
Practice Address - Phone:615-333-7971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM0000000190213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNT61111Medicare UPIN
TN3351398Medicare PIN