Organization
DAVID R. TOMAZIC, D.O., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID R. TOMAZIC D.O. (PRESIDENT)
(570) 785-5599
Entity
Organization
Contact information
Practice address
632 MAIN ST, FOREST CITY, PA 18421-1483
(570) 785-5599
(570) 785-3552
Mailing address
632 MAIN ST, FOREST CITY, PA 18421-1483
(570) 785-5599
(570) 785-3552
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS004178L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040568
PA BLUE SHIELD
PA
01
—
080001919
RAILROAD MEDICARE
—
05
—
102107900001
—
PA
Enumeration date
04/07/2008
Last updated
11/19/2008
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