Provider Demographics
NPI:1295832533
Name:TATMAN, ANTHONY WAYNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:WAYNE
Last Name:TATMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314
Mailing Address - Country:US
Mailing Address - Phone:515-242-6582
Mailing Address - Fax:515-242-6625
Practice Address - Street 1:2404 FOREST DR
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-5400
Practice Address - Country:US
Practice Address - Phone:515-282-0304
Practice Address - Fax:515-282-1328
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01008103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical