| Christopher D Tanner, MD | |
|
151 E Redstone Ave, Crestview, FL 32539-5352 | |
| (850) 650-5161 | |
| Not Available |
| Full Name | Christopher D Tanner |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 151 E Redstone Ave, Crestview, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932151792 | NPI | - | NPPES |
| 23573 | Other | FL | BCBS |
| 374014500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | ME65153 (Florida) | Primary |
| Entity Name | Primecare At Twin Lakes Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902809122 PECOS PAC ID: 3072591924 Enrollment ID: O20040708000867 |
| Entity Name | Northwest Florida Healthcare, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336163708 PECOS PAC ID: 2668363771 Enrollment ID: O20050627000512 |
| Entity Name | Southland Hospitalist At Weems Pl |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801170113 PECOS PAC ID: 2860667508 Enrollment ID: O20111208000449 |
| Entity Name | Southland Ems At Weems Pl |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124302443 PECOS PAC ID: 8820263171 Enrollment ID: O20111214000834 |
| Entity Name | Small Hospital Innovations Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184040560 PECOS PAC ID: 0840415444 Enrollment ID: O20140715000513 |
| Mailing Address | Practice Location Address |
|---|---|
| Christopher D Tanner, MD 200 Corporate Blvd, Suite 200, Lafayette, LA 70508-3870 Ph: (800) 893-9698 | Christopher D Tanner, MD 151 E Redstone Ave, Crestview, FL 32539-5352 Ph: (850) 650-5161 |
Dr. Tommy Steven Noggle, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 151 E Redstone Ave, Crestview, FL 32539 Phone: 850-689-2552 | |
Huy Bao Nguyen, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 151 E Redstone Ave, Crestview, FL 32539 Phone: 850-434-2853 | |
Dr. Tommy Glen Thompson Ii, M.D. Emergency Medicine Medicare: May Accept Medicare Assignments Practice Location: 151 E Redstone Ave, Crestview, FL 32539 Phone: 850-689-8100 | |
Regina Gilmore Haskin, NP Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 151 E. Redstone Avenue Se, Crestview, FL 32539 Phone: 850-689-8100 |