Individual
TANNER EVERHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
915 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1443
(765) 463-2424
(765) 463-2249
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02007534A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
IN
Other
Enumeration date
04/21/2021
Last updated
07/24/2024
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