Provider Demographics
NPI:1134831480
Name:DARDEN, TAMIKA (RTT)
Entity type:Individual
Prefix:
First Name:TAMIKA
Middle Name:
Last Name:DARDEN
Suffix:
Gender:F
Credentials:RTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 BERNICE DR
Mailing Address - Street 2:
Mailing Address - City:BOGART
Mailing Address - State:GA
Mailing Address - Zip Code:30622-1541
Mailing Address - Country:US
Mailing Address - Phone:706-621-1625
Mailing Address - Fax:
Practice Address - Street 1:165 BERNICE DR
Practice Address - Street 2:
Practice Address - City:BOGART
Practice Address - State:GA
Practice Address - Zip Code:30622-1541
Practice Address - Country:US
Practice Address - Phone:706-621-1625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5898982085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology