| John M Tatum Md Pa | |
|
2180 N Park Ave Suite 326 Winter Park FL 32789-2359 | |
| (407) 644-3593 | |
| (407) 644-1713 |
| Full Name | John M Tatum Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2180 N Park Ave, Winter Park, Florida |
| Authorized Official Name and Position | John M Tatum (OWNER) |
| Authorized Official Contact | 4076443593 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John M Tatum Md Pa 2180 N Park Ave Suite 326 Winter Park FL 32789-2359 Ph: (407) 644-3593 | John M Tatum Md Pa 2180 N Park Ave Suite 326 Winter Park FL 32789-2359 Ph: (407) 644-3593 |
| NPI Number | 1558582254 |
|---|---|
| Provider Enumeration Date | 05/01/2007 |
| Last Update Date | 05/17/2017 |
| Medicare PECOS PAC ID | 9830298033 |
|---|---|
| Medicare Enrollment ID | O20070629000210 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558582254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME0030885 (Florida) | Primary |
| Provider Name | John M Tatum |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639194145 PECOS PAC ID: 1254437643 Enrollment ID: I20070501000473 |
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