Individual
DEON LYNN TADLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
605 NEW YORK RANCH RD, JACKSON, CA 95642-9328
(209) 223-2030
(209) 223-2303
Mailing address
PO BOX 1749, JACKSON, CA 95642-1749
(209) 223-2030
(209) 223-2303
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A73693
CA
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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