Individual
GREGORY R. TOOTHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4015 GATEWAY BLVD, NEWBURGH, IN 47630-8925
(812) 858-9400
(812) 858-9571
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 858-9400
(812) 858-9571
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01047543A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000190630
BCBS PIN
IN
05
—
200042740
—
IN
Enumeration date
05/31/2005
Last updated
03/12/2013
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