Individual
DR. LYDIA CHANEY TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 DOCTORS DR STE G, DOUGLAS, GA 31533-2211
(912) 384-6186
(912) 384-6187
Mailing address
PO BOX 1377, DOUGLAS, GA 31534-1377
(912) 384-1477
(912) 384-1470
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
53885
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
053885
MEDICAL LICENSE
GA
05
—
366115747A
—
GA
05
—
366115747B
—
GA
Enumeration date
07/27/2006
Last updated
07/21/2022
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