Stewart H Tankersley, Md, Llc | |
1758 Park Pl Suite 200 Montgomery AL 36106-1127 | |
(334) 538-9695 | |
Not Available |
Full Name | Stewart H Tankersley, Md, Llc |
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Speciality | Clinic/Center |
Location | 1758 Park Pl, Montgomery, Alabama |
Authorized Official Name and Position | Stewart Tankersley (MD) |
Authorized Official Contact | 3345389695 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Stewart H Tankersley, Md, Llc 2432 Hawthorn Dr Montgomery AL 36111-1617 Ph: () - | Stewart H Tankersley, Md, Llc 1758 Park Pl Suite 200 Montgomery AL 36106-1127 Ph: (334) 538-9695 |
NPI Number | 1093068900 |
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Provider Enumeration Date | 10/17/2012 |
Last Update Date | 12/05/2012 |
Medicare PECOS PAC ID | 2365694577 |
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Medicare Enrollment ID | O20121217000405 |
Identifier | Type | State | Issuer |
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1093068900 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Stewart H Tankersley |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1952375917 PECOS PAC ID: 2769371103 Enrollment ID: I20040312001022 |
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