Provider Demographics
NPI:1982819397
Name:TAMRA WHITELEY-MYERS MD PC
Entity Type:Organization
Organization Name:TAMRA WHITELEY-MYERS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WHITELEY-MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-327-4442
Mailing Address - Street 1:5190 E FARNESS DR STE 110
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2142
Mailing Address - Country:US
Mailing Address - Phone:520-327-4442
Mailing Address - Fax:520-327-5038
Practice Address - Street 1:5190 E FARNESS DR STE 110
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2142
Practice Address - Country:US
Practice Address - Phone:520-327-4442
Practice Address - Fax:520-327-5038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZE31344Medicare UPIN
AZZMD12286Medicare PIN