Individual
DR. STEPHANIE CRABTREE TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, DEPARTMENT OF PATHOLOGY, JACKSON, MS 39216-4500
(601) 984-1530
(601) 984-1531
Mailing address
2500 N STATE ST, UNIVERSITY OF MS DEPT OF PATHOLOGY, JACKSON, MS 39216-4500
(601) 984-1530
(601) 984-1531
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
22388
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08639544
—
MS
01
—
P01271437
RAILROAD MEDICARE
MS
Enumeration date
06/05/2013
Last updated
03/21/2014
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