Provider Demographics
NPI:1548916372
Name:TOMPKINS, JOHN ROBERT (OD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ROBERT
Last Name:TOMPKINS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:896 FARMSTEAD RD
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-5256
Mailing Address - Country:US
Mailing Address - Phone:301-697-9927
Mailing Address - Fax:
Practice Address - Street 1:3350 BUFORD DR # 230
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-4991
Practice Address - Country:US
Practice Address - Phone:678-318-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003397152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist