NPI 1093123838
Tommy L Louisville MD PA
Practice location
- Address
- 320 1st St S, Winter Haven, FL 33880-3501
- Phone
- (863) 299-8485
- Mailing address
- 5626 Oberlin Dr Suite 110, San Diego, CA 92121-1705
Authorised official
- Name
- Kenny Heine
- Title
- Vp of Operations
- Phone
- (858) 964-1506
Registered specialties
Non-Pharmacy Dispensing Site
Primary
Registry record
- NPI
- 1093123838
- Entity type
- Organization
- NPI issued
- 24 Jul 2014
- Record last updated
- 24 Jul 2014
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.