Provider Demographics
NPI:1770665390
Name:ENGLISH, TAMMY CAROL (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:CAROL
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:TAMMY
Other - Middle Name:CAROL
Other - Last Name:DAVENPORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:PO BOX 968
Mailing Address - Street 2:
Mailing Address - City:TULLULAH
Mailing Address - State:LA
Mailing Address - Zip Code:71284-0968
Mailing Address - Country:US
Mailing Address - Phone:318-574-5273
Mailing Address - Fax:318-574-2218
Practice Address - Street 1:1901 MISSION 66
Practice Address - Street 2:SUITE A
Practice Address - City:VICKSBURG
Practice Address - State:MS
Practice Address - Zip Code:39180-3711
Practice Address - Country:US
Practice Address - Phone:601-638-4076
Practice Address - Fax:601-638-4979
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT 0694225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS5862641OtherAETNA
MS000050976OtherBLUE CROSS BLUE SHIELD
MS00119908Medicaid
MS254533Medicare ID - Type UnspecifiedMEDICARE#