Individual
CHARLES GARY TOMBERLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
848 S 3 NOTCH ST, ANDALUSIA, AL 36420-5320
(334) 222-5673
(334) 222-8754
Mailing address
PO BOX 27, ANDALUSIA, AL 36420-1200
(334) 222-5673
(334) 222-8754
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
3233
AL
2085R0202X
Diagnostic Radiology Physician
Primary
3233
AL
2085U0001X
Diagnostic Ultrasound Physician
3233
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000006385
—
AL
Enumeration date
04/25/2006
Last updated
05/21/2008
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