Individual
PAUL R TANNER
Active
Individual
PAUL R TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25372
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115692
—
MS
01
—
3016599
BCBS
TN
05
—
3092642
—
TN
01
—
97090
BCBS
AR
01
—
P00074329
MEDICARE RR
MS
Enumeration date
08/19/2006
Last updated
07/08/2007
Update your record
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