Doctor Name: | DR. TIFFANY D MCCORMACK |
NPI Number: | 1083789481 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 12004 |
Business Practice Address: | 10791 Double R Boulevard Reno, NV - 895215856 |
Business Phone Number: | 7752842020 |
Business Fax Number: | 7752842023 |
Mailing Address: | 10791 Double R Boulevard, RENO |
State: | NV |
Postal Code: | 895215856 |
Phone Number: | 7752842020 |
Fax Number: | 7752842023 |
NPI Enumeration Date: | 11/21/2006 |
NPI Last Update Date: | 05/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 12004 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NV |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |