Individual
MR. MARTIN BRYAN TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 MEDICAL CENTER DR, SUITE 200, ALEXANDRIA, LA 71301-8124
(318) 487-1289
(318) 487-1254
Mailing address
2710 MARYE ST, ALEXANDRIA, LA 71301-4924
(318) 487-8349
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
012039
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164763
—
LA
Enumeration date
11/15/2005
Last updated
04/01/2008
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