Provider Demographics
NPI:1417934852
Name:HILL, TAMARA LYN (MD)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:LYN
Last Name:HILL
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 1:309 SE FRANK PHILLIPS BLVD
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74003
Mailing Address - Country:US
Mailing Address - Phone:918-214-8888
Mailing Address - Fax:918-214-8887
Practice Address - Street 1:309 SE FRANK PHILLIPS BLVD
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003
Practice Address - Country:US
Practice Address - Phone:918-214-8888
Practice Address - Fax:918-214-8887
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK17349207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100201770AMedicaid
OKF47124Medicare UPIN