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1417185117 NPI number — TAMAR GIBLI MARCOTTE D.O.

NPI Number: 1417185117
Health Care Provider/Practitioner: TAMAR GIBLI MARCOTTE D.O.

Information about “1417185117” NPI (TAMAR GIBLI MARCOTTE D.O.) exists in 1417185117 in HTML format HTML  |  1417185117 in plain Text format TXT  |  1417185117 in PDF (Portable Document Format) PDF  |  1417185117 in an XML format XML  formats.

NPI Number : 1417185117 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1417185117",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MARCOTTE",
    "FirstName": "TAMAR",
    "MiddleName": "GIBLI",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.O.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GIBLI",
    "OtherFirstName": "TAMAR",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "D.O.",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 1055",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SOLDOTNA",
    "MailingAddressStateName": "AK",
    "MailingAddressPostalCode": "99669-1055",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "630-776-3554",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "35670 KENAI SPUR HWY STE 103A",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SOLDOTNA",
    "PracticeLocationAddressStateName": "AK",
    "PracticeLocationAddressPostalCode": "99669-7649",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "907-260-1655",
    "PracticeLocationAddressFaxNumber": "980-495-8870",
    "EnumerationDate": "07/01/2009",
    "LastUpdateDate": "11/24/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": "106902",
        "LicenseNumberStateCode": "AK",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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