Provider Demographics
NPI:1609965698
Name:DUTTER, TAMARA L (MD)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:L
Last Name:DUTTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:L
Other - Last Name:HOLTAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1198
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79604-1198
Mailing Address - Country:US
Mailing Address - Phone:325-670-4372
Mailing Address - Fax:605-622-5127
Practice Address - Street 1:1900 PINE ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2432
Practice Address - Country:US
Practice Address - Phone:325-670-2277
Practice Address - Fax:325-672-8292
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.126897207L00000X
SD8472207L00000X
WY7092A207L00000X
TXQ6181207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology