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Individual
DR. ANTHONY JOHN TACKMAN
Active
Individual
DR. ANTHONY JOHN TACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
9901045
NC
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
9901045
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8912100
—
NC
Enumeration date
08/05/2006
Last updated
04/09/2010
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