Individual
MICHAEL TOMBLYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6019 WALNUT GROVE RD, MEMPHIS, TN 38120-2113
(901) 226-0340
(901) 226-0349
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
036140023
IL
2085R0001X
Radiation Oncology Physician
Primary
62366
TN
2085R0203X
Therapeutic Radiology Physician
ME104123
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000764300
—
FL
Enumeration date
02/17/2007
Last updated
04/28/2021
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