Individual
JOHN CLINTON TANNER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3366 OAKDALE AVE N, SUITE 103, ROBBINSDALE, MN 55422-2948
(763) 520-7870
(763) 520-7580
Mailing address
4200 DAHLBERG DR, SUITE 300, GOLDEN VALLEY, MN 55422-4840
(952) 512-5600
(952) 512-5651
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
109070
MN
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
4301090393
MI
Other
Enumeration date
07/03/2007
Last updated
08/26/2016
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