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Individual

DR. OWATHA LOYE TATUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D., HCLD/CC(ABB)

Contact information

Practice address
3415 56TH ST, LUBBOCK, TX 79413-4745
(806) 797-2879
Mailing address
3415 56TH ST, LUBBOCK, TX 79413-4745

Taxonomy

Speciality
Code
Description
License number
State
246ZG1000X
Medical Geneticist (PhD) Specialist/Technologist
TATU01
NY
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
DI43809
FL

Other

Enumeration date
06/04/2013
Last updated
06/22/2015
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