Individual
MR. ANTHONY DAVID TARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
4600 MEMORIAL DR STE 120, BELLEVILLE, IL 62226-5359
(618) 222-1020
Mailing address
4600 MEMORIAL DR STE 120, BELLEVILLE, IL 62226-5359
(618) 222-1020
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
041405030
IL
163WC0200X
Critical Care Medicine Registered Nurse
2012004299
MO
363LF0000X
Family Nurse Practitioner
Primary
209016200
IL
Other
Enumeration date
11/15/2016
Last updated
05/17/2021
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