Provider Demographics
NPI:1750361200
Name:SMITH, TAMMY LYNN (DO)
Entity type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:LYNN
Last Name:SMITH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:SMITH
Other - Last Name:GERSTENFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PSC 482, BOX 252
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96367
Mailing Address - Country:US
Mailing Address - Phone:01181611-743-7267
Mailing Address - Fax:
Practice Address - Street 1:PSC 482, BOX 252
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96367
Practice Address - Country:US
Practice Address - Phone:01181611-743-7267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A 5345207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine