Basic Information
| Provider Information | |||||||||
| NPI: | 1639162522 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOMLINSON | ||||||||
| FirstName: | GREGORY | ||||||||
| MiddleName: | CHARLES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8773 PERIMETER PARK CT | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322161165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9044933390 | ||||||||
| FaxNumber: | 9044933395 | ||||||||
| Practice Location | |||||||||
| Address1: | 7807 BAYMEADOWS RD E | ||||||||
| Address2: | STE 209 | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322569664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043301024 | ||||||||
| FaxNumber: | 9043301027 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2005 | ||||||||
| LastUpdateDate: | 08/04/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | ME86960 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | ME86960 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 0103467-00 | 01 | FL | FL MEDICAID - GROUP | OTHER | HR822A | 01 | FL | FL MEDICARE - GROUP | OTHER | 004XP | 01 | FL | FLORIDA BLUE - GROUP | OTHER | 10786680 | 01 | FL | CIGNA | OTHER | P00030751 | 01 | RAILROAD | OTHER | 0015008-00 | 05 | FL | MEDICAID | 003119716A | 01 | GA | GEORGIA MEDICAID - INDIVIDUAL | OTHER | 295965 | 01 | FL | AVMED | OTHER |