Smith, Tamara Marie

Smith, Tamara Marie is an individual health care provider with primary practice located at 525 E. Grant Street Outpatient Services Suite, Macomb IL 61455. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Smith, Tamara Marie can be contacted via phone (309) 836-6937.

Contact Information

Primary practice address
525 E. Grant Street Outpatient Services Suite Macomb IL 61455
Phone: (309) 836-6937
Fax: (309) 836-6530
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 20A6984 California
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 036-126160 Illinois

Profile Details

NPI number 1932118239
LBN Legal business name Smith, Tamara Marie
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2006
Last updated Apr 6th, 2023 - about 2 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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Identifiers

StateTypeNumberIssuer
All States NPI 1932118239 NPPES
California MEDICAID 00AX69840

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