Individual
CLINT STEVEN TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
#DR.0054779
CO
2084P0800X
Psychiatry Physician
MD-2013-0763
NM
Other
Enumeration date
04/18/2011
Last updated
08/03/2020
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