Individual
REBECCA I. TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1160 E 3900 S, SUITE G200, SALT LAKE CITY, UT 84124-1202
(801) 268-7766
Mailing address
PO BOX 271220, SALT LAKE CITY, UT 84127-1220
(801) 736-0110
(801) 366-9883
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3258511205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PR67234
—
UT
Enumeration date
11/18/2005
Last updated
09/15/2010
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