Individual
LISETTE DAVIDSON TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., MPH
Contact information
Practice address
2000 10TH AVE STE 100, COLUMBUS, GA 31901-3703
(706) 571-1285
Mailing address
6410 FANNIN ST, SUITE 210, HOUSTON, TX 77030-3000
(832) 325-7288
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
86451
GA
207V00000X
Obstetrics & Gynecology Physician
A131471
CA
207VM0101X
Maternal & Fetal Medicine Physician
Primary
86451
GA
Other
Enumeration date
03/22/2012
Last updated
08/30/2024
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