Provider Demographics
NPI:1851531818
Name:PAYNE, TAMMY A (HAD)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:A
Last Name:PAYNE
Suffix:
Gender:F
Credentials:HAD
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:
Other - Last Name:DEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1029 SLATECREEK WAY
Mailing Address - Street 2:
Mailing Address - City:LONSDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72087-9710
Mailing Address - Country:US
Mailing Address - Phone:501-276-3431
Mailing Address - Fax:
Practice Address - Street 1:1217 MALVERN AVE STE C
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-6375
Practice Address - Country:US
Practice Address - Phone:501-701-4388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
237700000X
AR605237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist