Tanner Medical Clinic Llc | |
20104 Swanner Blvd Suite 4 Tanner AL 35671-3651 | |
(256) 686-3334 | |
(256) 686-3339 |
Full Name | Tanner Medical Clinic Llc |
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Speciality | Clinic/Center |
Location | 20104 Swanner Blvd, Tanner, Alabama |
Authorized Official Name and Position | Michelle Sloan Graham (VP OF OPERATIONS) |
Authorized Official Contact | 2564322822 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tanner Medical Clinic Llc 20104 Swanner Blvd Tanner AL 35671-3651 Ph: (256) 686-3334 | Tanner Medical Clinic Llc 20104 Swanner Blvd Suite 4 Tanner AL 35671-3651 Ph: (256) 686-3334 |
NPI Number | 1376881870 |
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Provider Enumeration Date | 01/18/2013 |
Last Update Date | 05/23/2023 |
Medicare PECOS PAC ID | 8921245796 |
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Medicare Enrollment ID | O20130515000221 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376881870 | NPI | - | NPPES |
159174 | Medicaid | AL |
Provider Name | Gregory S Cheatham |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1003844754 PECOS PAC ID: 4486620697 Enrollment ID: I20040909000149 |
Provider Name | Johnna Hines Langford |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427311331 PECOS PAC ID: 9638498546 Enrollment ID: I20150427001723 |
Provider Name | Kimberley Brooke Tanner |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023537073 PECOS PAC ID: 1658612049 Enrollment ID: I20190412000024 |
Provider Name | Michelle Sloan Graham |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255894994 PECOS PAC ID: 5395088041 Enrollment ID: I20190520002873 |
Provider Name | Halli Flannagin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215598511 PECOS PAC ID: 4688902323 Enrollment ID: I20190820001316 |
Tanner Community Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11185 Hwy 31, Tanner, AL 35671 Phone: 256-216-9658 Fax: 256-216-9659 |