Basic Information
| Provider Information | |||||||||
| NPI: | 1467498899 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOMPKINS | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1431 CENTERPOINT BLVD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379321984 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655398000 | ||||||||
| FaxNumber: | 8659857077 | ||||||||
| Practice Location | |||||||||
| Address1: | 2333 MCCALLIE AVE | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374043258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4236986061 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2006 | ||||||||
| LastUpdateDate: | 10/11/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 31463 | TN | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000940233C | 05 | GA | MEDICAID | 3857095 | 05 | TN | MEDICAID | 3857094 | 05 | TN | MEDICAID | 4142255 | 01 | TN | BCBS OF TN | OTHER | 000940233B | 05 | GA | MEDICAID | 009941817 | 05 | AL | MEDICAID | P00377626 | 01 | TN | RAILROAD MEDICARE | OTHER |