Provider Demographics
NPI:1013108463
Name:HARVEY, TAMMY (DO)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:HARVEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3321 W ESPLANADE AVE S
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-3421
Mailing Address - Country:US
Mailing Address - Phone:504-266-2444
Mailing Address - Fax:504-266-2445
Practice Address - Street 1:3321 W ESPLANADE AVE S
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3421
Practice Address - Country:US
Practice Address - Phone:504-266-2444
Practice Address - Fax:504-266-2445
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LADO.000121207R00000X, 208000000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1217085Medicaid