Individual
TAMBREA TOYLETT ELLISON
Active
Individual
TAMBREA TOYLETT ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL30874
SC
208100000X
Physical Medicine & Rehabilitation Physician
Primary
69187
GA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
69187
GA
208VP0000X
Pain Medicine Physician
69187
GA
208VP0014X
Interventional Pain Medicine Physician
69187
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003137503A
—
GA
05
—
003137503B
—
GA
05
—
003137503C
—
GA
05
—
003137503D
—
GA
05
—
003137503E
—
GA
05
—
003137503F
—
GA
Enumeration date
06/05/2008
Last updated
12/07/2016
Update your record
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