Healthcare Provider Details
I. General information
NPI: 1669760344
Provider Name (Legal Business Name): TAMARA SINGLETON, MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/15/2011
Last Update Date: 10/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1167A HWY 554
EL RITO NM
87530
US
IV. Provider business mailing address
PO BOX 805
EL RITO NM
87530-0805
US
V. Phone/Fax
- Phone: 575-581-0033
- Fax: 575-581-0034
- Phone: 575-581-0033
- Fax: 575-581-0034
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TAMARA
ALYNN
SINGLETON
Title or Position: OWNER/DOCTOR
Credential: M.D.
Phone: 575-581-0033