Individual
DR. MARSHALL GLYNN TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2016 OCILLA RD, DOUGLAS, GA 31533-2230
(912) 384-4010
(912) 384-4018
Mailing address
710 N IRWIN AVE, SUITE 106, OCILLA, GA 31774-5011
(229) 468-3800
(229) 468-9991
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
056658
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00567102T
—
GA
Enumeration date
08/30/2005
Last updated
04/21/2016
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