Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 34052 | IA |
Y | 207K00000X | Allergist & Immunologist | ME151184 | FL |
N | 207KA0200X | Allergist | 34052 | IA |
N | 207KA0200X | Allergist | ME151184 | FL |
NPI | 1528068558 |
---|---|
Provider Name | Mr. Christopher Daniel Tumpkin |
First Address | Sarasota, FL 34239 |
Second Address | Sarasota, FL 34239 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2005 |
Last Update Date | 15/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
023803 | (05) | IA |
H41343 | (02) | IA |