Individual
CHAUNCEY DENISE TARRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-7018
Mailing address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-7018
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
26470
NE
Other
Enumeration date
04/01/2010
Last updated
08/13/2014
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