Provider Demographics
NPI:1417185117
Name:MARCOTTE, TAMAR GIBLI (DO)
Entity Type:Individual
Prefix:DR
First Name:TAMAR
Middle Name:GIBLI
Last Name:MARCOTTE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TAMAR
Other - Middle Name:
Other - Last Name:GIBLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 1055
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-1055
Mailing Address - Country:US
Mailing Address - Phone:630-776-3554
Mailing Address - Fax:
Practice Address - Street 1:35670 KENAI SPUR HWY STE 103A
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7649
Practice Address - Country:US
Practice Address - Phone:907-260-1655
Practice Address - Fax:980-495-8870
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2019-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK106902207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine