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Individual

JOHN M TANNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
601 DR MARTIN LUTHER KING JR AVE NE, INPATIENT NEUROLOGY, ALBUQUERQUE, NM 87102-3619
(505) 238-3168
Mailing address
6100 PAN AMERICAN EAST FWY NE, SUITE 100, ALBUQUERQUE, NM 87109-3427

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD 2009 0170
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6836569
NM
Enumeration date
08/31/2006
Last updated
07/20/2015
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