Individual
TANNER GREGORY WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17 DAVIS BLVD, SUITE 308, TAMPA, FL 33606-3475
(813) 250-2506
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-2812
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME140677
FL
208M00000X
Hospitalist Physician
Primary
ME140677
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103511700
—
FL
01
—
KR8I4
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/18/2016
Last updated
08/24/2021
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