Individual
TANNER DEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8533 E 32ND ST N, WICHITA, KS 67226-2611
(316) 293-3455
(855) 487-3302
Mailing address
1010 N KANSAS ST, WICHITA, KS 67214-3124
(316) 293-2665
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
05-46297
KS
207R00000X
Internal Medicine Physician
94-09886
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30004650330002
—
KS
Enumeration date
05/29/2019
Last updated
06/19/2023
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