| Anthony T Tanner, | |
| 
					7001 Hwy 614, Hurley, MS 39555  | |
| (228) 588-2938 | |
| (228) 588-9399 | 
| Full Name | Anthony T Tanner | 
|---|---|
| Gender | Male | 
| Speciality | Nurse Practitioner | 
| Location | 7001 Hwy 614, Hurley, Mississippi | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1275804270 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363L00000X | Nurse Practitioner | R205397-4 (Minnesota) | Primary | 
| Entity Name | Singing River Health System | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1083893937 PECOS PAC ID: 3870405194 Enrollment ID: O20031104000435  | 
| Entity Name | Singing River Gulfport | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1861010159 PECOS PAC ID: 5294154829 Enrollment ID: O20201001001497  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Anthony T Tanner, Po Box 850, Hurley, MS 39555-0850 Ph: (228) 588-2938  | Anthony T Tanner, 7001 Hwy 614, Hurley, MS 39555 Ph: (228) 588-2938  | 
Ashley Williams Becker, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7001 Hwy 614, Hurley, MS 39555 Phone: 228-588-6622  | |
Domonique Nikki Cochran, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7001 Hwy 614, Hurley, MS 39555 Phone: 228-588-2938 Fax: 228-588-9399  |