Healthcare Provider Details

I. General information

NPI: 1972265130
Provider Name (Legal Business Name): TALLAHASSEE MEDICAL GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2021
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 SURGEONS DRIVE SUITE A
TALLAHASSEE FL
32308
US

IV. Provider business mailing address

1511 SURGEONS DRIVE SUITE A
TALLAHASSEE FL
32308
US

V. Phone/Fax

Practice location:
  • Phone: 850-878-6134
  • Fax: 850-309-0354
Mailing address:
  • Phone: 850-878-6134
  • Fax: 850-309-0354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. HUGH VANLANDINGHAM
Title or Position: MGR
Credential: MD
Phone: 850-878-6134