Provider Demographics
NPI:1205908126
Name:HEARST, TAMARA E (MD)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:E
Last Name:HEARST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1200 N E 13TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73152-3277
Mailing Address - Country:US
Mailing Address - Phone:405-522-8100
Mailing Address - Fax:405-522-4120
Practice Address - Street 1:1200 N E 13TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73152-3277
Practice Address - Country:US
Practice Address - Phone:405-522-8100
Practice Address - Fax:405-522-4120
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK224812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry