| Doctor Name: | TAMMY L HUMPHRIES |
| NPI Number: | 1912034588 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 13020 |
| Business Practice Address: | 16601 E Centretech Pkwy Aurora, CO - 800119045 |
| Business Phone Number: | 3037393547 |
| Business Fax Number: | |
| Mailing Address: | 1178 Deer Blvd E, AVON |
| State: | CO |
| Postal Code: | 81620 |
| Phone Number: | 9707480234 |
| Fax Number: | |
| NPI Enumeration Date: | 02/28/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 13020 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |