Individual
TAMELA TRIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
50 E DUNLAP AVE, SUITE 105, PHOENIX, AZ 85020-2877
(602) 944-4626
(602) 944-2805
Mailing address
50 E DUNLAP AVE, SUITE 105, PHOENIX, AZ 85020-2877
(602) 944-4626
(602) 944-2805
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13488
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070004490
RAILROAD MEDICARE
AZ
05
—
273706001
—
AZ
01
—
AZ0250130
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
09/21/2005
Last updated
06/10/2008
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