Individual
DR. MARTINA ABENA TAMAKLOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
401 E VAUGHN AVE, RUSTON, LA 71270-5950
(318) 254-2100
Mailing address
327 JEFFERSON OAKS DR, RUSTON, LA 71270-7080
(318) 254-3001
(318) 254-2962
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35190
LA
207R00000X
Internal Medicine Physician
E-11439
AR
207R00000X
Internal Medicine Physician
Primary
MD.201853
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1331767
—
LA
Enumeration date
07/12/2006
Last updated
11/18/2022
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