Individual
JED C TOMPKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8911 LIBERTY MILLS RD, FORT WAYNE, IN 46804-6311
(260) 373-9465
(260) 266-9406
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02004310A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201092930
—
IN
Enumeration date
06/13/2012
Last updated
10/20/2022
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