Individual
DR. DAVID ALAN TACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 S CARSON ST, CARSON CITY, NV 89701-5232
(775) 883-7811
Mailing address
227 ST ALBANS PL, CARSON CITY, NV 89703-4546
(775) 841-5259
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
11209
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11209
NV STATE MED. LIC #
NV
Enumeration date
07/28/2006
Last updated
07/08/2007
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