Individual
WILLIAM STEPHEN TANKERSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16915 HIGHWAY 67 SOUTH, SUITE A, STATESBORO, GA 30458
(912) 681-2500
(912) 681-2025
Mailing address
210 EAST DERENNE AVE, ATTN- PROVIDER ENROLLMENT, SAVANNAH, GA 31405
(912) 644-5300
(912) 644-5260
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
034484
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0382260001
DMERC MEDICARE SUPPLIES
—
01
—
0942075
UNITED HEALTHCARE
—
01
—
12043
BCBS OF NC
—
01
—
200036693
RAILROAD MEDICARE
—
01
—
2167312
AETNA US HEALTHCARE
—
01
—
23258
PRINCIPAL HEALTHCARE
—
01
—
31743
PARTNERS MEDICARE
—
05
—
380326550B
—
GA
01
—
53003473
AETNA
—
01
—
5374830002
CIGNA HEALTHCARE
—
01
—
89026
MEDCOST
—
05
—
8912043
—
NC
Enumeration date
02/15/2006
Last updated
01/14/2014
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