Provider Demographics
NPI:1619214137
Name:EBERLE, TAMMY NEWMAN (MD, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:NEWMAN
Last Name:EBERLE
Suffix:
Gender:F
Credentials:MD, PHARMD
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 17806
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38187-0806
Mailing Address - Country:US
Mailing Address - Phone:901-870-0708
Mailing Address - Fax:
Practice Address - Street 1:1040 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-2127
Practice Address - Country:US
Practice Address - Phone:901-523-8990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000005608183500000X
TNMD0000040698208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice