Organization
TANNER INTENSIVE MEDICAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN FOX (VP OPERATIONS)
(770) 838-8845
Entity
Organization
Contact information
Practice address
1032 MAIN ST S, WEDOWEE, AL 36278-7440
(256) 357-2111
Mailing address
1032 MAIN ST S, WEDOWEE, AL 36278-7440
(256) 357-2111
(256) 357-2165
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA8298
MEDICARE ID
GA
Enumeration date
07/30/2006
Last updated
02/06/2024
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