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Individual

TAMMY K. MCLEAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
6600 WHITTLESEY BLVD UNIT A, COLUMBUS, GA 31909-7334
(706) 323-3491
(706) 660-9191
Mailing address
6600 WHITTLESEY BLVD UNIT A, COLUMBUS, GA 31909-7334
(706) 323-3491
(706) 660-9191

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
053496
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
202I071208
MEDICARE PTAN
GA
05
695051329A
GA
05
695051329C
GA
01
P01338529
RAILROAD MEDICARE
GA
Enumeration date
07/27/2006
Last updated
12/06/2017
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