Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
IVAN ALEXIS LICEA TAMAYO, MD
ActiveIVAN ALEXIS LICEA TAMAYO, MD is a Family Medicine healthcare provider located in MONTGOMERY, Alabama. NPI 1669895223 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · MONTGOMERY, AL
Registration Details
- NPI Number
- 1669895223
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 31, 2014 (12.536787739714 yrs)
- Last Updated
- Jan 31, 2014
- Licenses
-
ME 118521 (FL)L3510R (AL)
Practice Information
- Address
-
4371 NARROW LANE RDMONTGOMERY, AL, 361162971Browse AL providers · Browse ZIP 36116
- Phone
- 3346133680
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
Other Family Medicine Providers in MONTGOMERY, AL
| Name | Credential | NPI |
|---|---|---|
| DR. VICTOR GASTON THERIAULT | MD | 1396742318 |
| DR. THOMAS M GOODMAN | M.D. | 1609874882 |
| MS. LOUISA M TOLENTINO | MD | 1770583296 |
| MR. ROBERT H MOON | MD | 1801896980 |
| DR. DIXIE DAWN KIDD | D.O. | 1265427413 |
| DR. KYNARD LEVI ADAMS | MD | 1700873494 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.