Individual
DR. ALAN J TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
30828
IA
2085R0202X
Diagnostic Radiology Physician
7411
SD
2085R0202X
Diagnostic Radiology Physician
Primary
G72011
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IA30828
LICENSE
IA
Enumeration date
09/27/2006
Last updated
12/16/2021
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