| Tanner Bridge Clinic Inc | |
|
1480 S Highway 27 Ste B Carrollton GA 30117-8901 | |
| (770) 812-5900 | |
| (770) 812-5584 |
| Full Name | Tanner Bridge Clinic Inc |
|---|---|
| Speciality | Emergency Medicine |
| Location | 1480 S Highway 27 Ste B, Carrollton, Georgia |
| Authorized Official Name and Position | Clint Hoffman (SENIOR VP TANNER MEDICAL GROUP) |
| Authorized Official Contact | 7708125304 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tanner Bridge Clinic Inc 100 Greenway Blvd Box C Carrollton GA 30117-4358 Ph: (770) 838-8710 | Tanner Bridge Clinic Inc 1480 S Highway 27 Ste B Carrollton GA 30117-8901 Ph: (770) 812-5900 |
| NPI Number | 1770391047 |
|---|---|
| Provider Enumeration Date | 12/19/2024 |
| Last Update Date | 05/19/2025 |
| Medicare PECOS PAC ID | 4587194659 |
|---|---|
| Medicare Enrollment ID | O20250205002445 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770391047 | NPI | - | NPPES |
| Provider Name | Jesse R Mitchell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063479863 PECOS PAC ID: 9234031089 Enrollment ID: I20050120000623 |
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