Individual
TAMMY L BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7400 LYNN AVE, HAMLIN, WV 25523-1138
(304) 824-5806
(304) 824-5804
Mailing address
7400 LYNN AVE, HAMLIN, WV 25523-1138
(304) 824-5806
(304) 824-5885
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18587
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0054648000
—
WV
05
—
2025632
—
OH
05
—
64941651
—
KY
Enumeration date
03/27/2006
Last updated
11/18/2025
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