Individual
TIMOTHY H TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
26 CEDAR LN, DANVILLE, VT 05828-9751
(802) 684-2275
(802) 684-3839
Mailing address
165 SHERMAN DR, ST JOHNSBURY, VT 05819-9811
(802) 748-9405
(802) 748-4540
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0420008723
VT
208000000X
Pediatrics Physician
0420008723
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN0612
—
VT
Enumeration date
04/13/2006
Last updated
07/16/2010
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