Individual
MR. DOUGLAS TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGNP-C
Contact information
Practice address
801 MEDICAL CT E, INVERNESS, FL 34452-4623
(352) 765-3434
Mailing address
8853 E HENDERSON TRL, INVERNESS, FL 34450-8879
(330) 322-6856
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
APRN11018465
FL
Other
Enumeration date
03/07/2022
Last updated
03/07/2022
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