Basic Information
Provider Information
NPI: 1730673948
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOMLINSON
FirstName: HENRY
MiddleName: HOLLAND
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 169 ASHLEY AVENUE
Address2: ROOM 202 MAIN HOSPITAL, MSC333
City: CHARLESTON
State: SC
PostalCode: 294258905
CountryCode: US
TelephoneNumber: 8437922322
FaxNumber:  
Practice Location
Address1: 167 ASHLEY AVENUE
Address2: SUITE 301, MSC 912
City: CHARLESTON
State: SC
PostalCode: 294259120
CountryCode: US
TelephoneNumber: 8437922322
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/20/2018
LastUpdateDate: 04/24/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/24/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XLL52808SCY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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