Individual
DILLON MICHAEL TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
1728 11TH AVE, HALEYVILLE, AL 35565-1506
(205) 465-7822
(260) 399-4004
Mailing address
1728 11TH AVE, HALEYVILLE, AL 35565-1506
(205) 485-7822
(260) 399-4004
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
906197
MS
Other
Enumeration date
04/10/2023
Last updated
12/19/2023
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