Individual
GARY TANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
910 SW 1093 PRIVATE ROAD, MONTROSE, MO 64770
(660) 492-7656
Mailing address
910 SW 1093 PRIVATE ROAD, MONTROSE, MO 64770
(660) 492-7656
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R5125
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA1555001
MEDICARE NUMBER
MO
Enumeration date
08/22/2007
Last updated
11/28/2011
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