Individual ProviderJakub TomczykFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address201 Cassell Dr, Kingsport, TN 37660-3747(423) 245-9626PECOS EnrollmentBased on the most recent information from CMS, provider Jakub Tomczyk does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 4:18 PM.Profile DetailsProvider ID1104954700Provider TypeIndividualFull NameTomczyk, JakubCredentialMDGenderMaleSole ProprietorNoEnumeration Date3/2/2007Last Updated1/17/2011Contact InformationPractice LocationPractice Address201 Cassell Dr, Kingsport, TN 37660-3747Phone(423) 245-9626FaxUnlisted FaxMailing LocationMailing Address201 Cassel Dr, Kingsport, TN 37660Phone(423) 245-9626FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense0101247437VirginiaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer