Provider Demographics
NPI:1265039101
Name:HUNSUCKER, TAMMIE FAYE
Entity Type:Individual
Prefix:
First Name:TAMMIE
Middle Name:FAYE
Last Name:HUNSUCKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 317
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:OK
Mailing Address - Zip Code:74062-0317
Mailing Address - Country:US
Mailing Address - Phone:405-414-7873
Mailing Address - Fax:
Practice Address - Street 1:406 E MAIN STREET
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:OK
Practice Address - Zip Code:74062
Practice Address - Country:US
Practice Address - Phone:405-414-7873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist