Individual
JASON F. TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3131 NEWMARK DR STE 210, MIAMISBURG, OH 45342-5400
(937) 438-8910
Mailing address
3131 NEWMARK DR STE 210, MIAMISBURG, OH 45342-5400
(260) 667-8913
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01072923A
IN
207P00000X
Emergency Medicine Physician
Primary
35.132469
OH
207P00000X
Emergency Medicine Physician
51681
KY
207Q00000X
Family Medicine Physician
01072923A
IN
207Q00000X
Family Medicine Physician
35.132469
OH
207Q00000X
Family Medicine Physician
51681
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0259042
—
OH
Enumeration date
06/29/2011
Last updated
09/09/2020
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