Healthcare Provider Details

I. General information

NPI: 1881779304
Provider Name (Legal Business Name): TAMARA ALYNN SINGLETON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAMARA SINGLETON BEKELE MD

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1167 HWY 554
EL RITO NM
87530
US

IV. Provider business mailing address

HC 77 BOX 12 34873A HWY 285
OJO CALIENTE NM
87549-9701
US

V. Phone/Fax

Practice location:
  • Phone: 505-581-0033
  • Fax:
Mailing address:
  • Phone: 505-583-2503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number96-371
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: