Mangum, Tara

Mangum, Tara is an individual health care provider with primary practice located at 1919 E Thomas Rd , Phoenix AZ 85016. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology. Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology is her primary health care specialty. Mangum, Tara can be contacted via phone (602) 933-0970.

Contact Information

Primary practice address
1919 E Thomas Rd Phoenix AZ 85016
Phone: (602) 933-0970
Fax: (602) 933-4253
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 76554 Georgia
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X 006652 Arizona

Profile Details

NPI number 1932428315
LBN Legal business name Mangum, Tara
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2010
Last updated Sep 6th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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