Provider Demographics
NPI:1104874957
Name:TOMPKINS, WILLIAM CHARLES JR (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CHARLES
Last Name:TOMPKINS
Suffix:JR
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 SAINT MICHAEL DR STE 307
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2343
Mailing Address - Country:US
Mailing Address - Phone:903-614-5356
Mailing Address - Fax:903-735-5399
Practice Address - Street 1:1801 GALLERIA OAKS DR
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-4616
Practice Address - Country:US
Practice Address - Phone:903-614-4495
Practice Address - Fax:903-614-5399
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE3130208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR127270000OtherQUALCHOICE
AR103376001Medicaid
AR770038801OtherBREAST CARE
TXTXB112012OtherMEDICARE UNSPECIFIED
AR103376001Medicaid