Provider Demographics
NPI:1881779304
Name:SINGLETON, TAMARA ALYNN (MD)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:ALYNN
Last Name:SINGLETON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:SINGLETON
Other - Last Name:BEKELE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:HC 77 BOX 12
Mailing Address - Street 2:34873A HWY 285
Mailing Address - City:OJO CALIENTE
Mailing Address - State:NM
Mailing Address - Zip Code:87549-9701
Mailing Address - Country:US
Mailing Address - Phone:505-583-2503
Mailing Address - Fax:
Practice Address - Street 1:1167 HWY 554
Practice Address - Street 2:
Practice Address - City:EL RITO
Practice Address - State:NM
Practice Address - Zip Code:87530
Practice Address - Country:US
Practice Address - Phone:505-581-0033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM96-371207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMG20085Medicare UPIN