Provider Demographics
NPI:1982014130
Name:TATMAN, LAUREN MACCORMICK (MD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:MACCORMICK
Last Name:TATMAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:CB 8233
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-514-3500
Mailing Address - Fax:314-747-2598
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:STE 6A/6B/12A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-747-2551
Practice Address - Fax:314-747-2598
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2020010875207XX0801X
TN59083207XX0801X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200085585Medicaid