Individual
MICHAEL S TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2720 OLD ROSEBUD RD STE 110, LEXINGTON, KY 40509-8005
(859) 373-0300
(859) 373-0024
Mailing address
2720 OLD ROSEBUD RD STE 110, LEXINGTON, KY 40509-8005
(859) 373-0300
(859) 373-0024
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
53534
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100680850
—
KY
Enumeration date
03/23/2016
Last updated
08/06/2020
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