Provider Demographics
NPI:1093962490
Name:CROUSE, TAMARA LOUISE (DO)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:LOUISE
Last Name:CROUSE
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:5325 FARAON ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-3488
Mailing Address - Country:US
Mailing Address - Phone:816-271-6406
Mailing Address - Fax:816-271-7986
Practice Address - Street 1:5325 FARAON ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3488
Practice Address - Country:US
Practice Address - Phone:816-271-6406
Practice Address - Fax:816-271-7986
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2021-01-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2008024817208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist