Provider Demographics
NPI:1386319259
Name:TORS MEDICAL CLINIC LLC
Entity type:Organization
Organization Name:TORS MEDICAL CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KLUMPP
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:337-526-9544
Mailing Address - Street 1:3501 MAPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:LA
Mailing Address - Zip Code:70663-6209
Mailing Address - Country:US
Mailing Address - Phone:337-561-5693
Mailing Address - Fax:949-561-5693
Practice Address - Street 1:3501 MAPLEWOOD DR
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:LA
Practice Address - Zip Code:70663-6209
Practice Address - Country:US
Practice Address - Phone:337-561-5693
Practice Address - Fax:949-561-5693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty