Individual
DUSTIN RYAN TOMPKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
940 W MOUNT VERNON ST, SUITE 200, NIXA, MO 65714-9618
(417) 724-5300
(417) 724-5303
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 820-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2014006562
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790077600
—
MO
Enumeration date
05/10/2011
Last updated
02/11/2015
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