Provider Demographics
NPI:1952555229
Name:WALDRON, TAMARA KAY (PA-C)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:KAY
Last Name:WALDRON
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6242 E ARBOR AVE
Mailing Address - Street 2:SUITE #111
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-1309
Mailing Address - Country:US
Mailing Address - Phone:480-610-8183
Mailing Address - Fax:480-610-8566
Practice Address - Street 1:6242 E ARBOR AVE
Practice Address - Street 2:SUITE #111
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1309
Practice Address - Country:US
Practice Address - Phone:480-610-8183
Practice Address - Fax:480-610-8566
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2014-02-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ4338363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant