Basic Information
Provider Information
NPI: 1629334214
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOKARS
FirstName: ROBERT
MiddleName: L.
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1742
Address2:  
City: SOUTH BEND
State: IN
PostalCode: 466341742
CountryCode: US
TelephoneNumber: 5742333123
FaxNumber: 5742333125
Practice Location
Address1: 5215 HOLY CROSS PKWY
Address2:  
City: MISHAWAKA
State: IN
PostalCode: 46545
CountryCode: US
TelephoneNumber: 5743355000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/09/2012
LastUpdateDate: 10/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X01078422AINY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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