Provider Demographics
NPI:1063733293
Name:RUMMEL, TOBIN D (DO)
Entity type:Individual
Prefix:
First Name:TOBIN
Middle Name:D
Last Name:RUMMEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 SW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-1725
Mailing Address - Country:US
Mailing Address - Phone:541-207-3773
Mailing Address - Fax:800-549-1017
Practice Address - Street 1:1760 SW 3RD ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-1725
Practice Address - Country:US
Practice Address - Phone:541-207-3773
Practice Address - Fax:800-549-1017
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPG151477207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine