Individual
CHRISTOPHER D. TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
151 E REDSTONE AVE, CRESTVIEW, FL 32539-5352
(850) 650-5161
Mailing address
200 CORPORATE BLVD, SUITE 200, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME65153
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23573
BCBS
FL
05
—
374014500
—
FL
Enumeration date
05/17/2006
Last updated
06/19/2009
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