Provider Demographics
NPI:1053849869
Name:ALEXANDER, TAMARA TAYLOR (MD)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:TAYLOR
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:TAYLOR
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3104 NW 34TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-6720
Mailing Address - Country:US
Mailing Address - Phone:918-638-9045
Mailing Address - Fax:
Practice Address - Street 1:1200 CHILDRENS AVE STE 14044
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-4637
Practice Address - Country:US
Practice Address - Phone:405-271-4417
Practice Address - Fax:405-271-2920
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-24
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program