Individual
JUSTIN TOMAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 GARRITY BLVD, NAMPA, ID 83687-3402
(208) 343-6458
Mailing address
127 N OAK AVE STE D, COOKEVILLE, TN 38501-2435
(931) 783-5857
(931) 526-6760
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125065349
IL
207RG0100X
Gastroenterology Physician
Primary
M-15090
ID
208M00000X
Hospitalist Physician
55672
TN
Other
Enumeration date
06/19/2014
Last updated
08/06/2020
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