Healthcare Provider Details
I. General information
NPI: 1871784645
Provider Name (Legal Business Name): TANNER FAMILY HEALTHCARE OF FRANKLIN INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/07/2007
Last Update Date: 05/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2906 FRANKLIN PKWY
FRANKLIN GA
30217-7544
US
IV. Provider business mailing address
PO BOX 896096
CHARLOTTE NC
28289-6096
US
V. Phone/Fax
- Phone: 706-675-6949
- Fax: 706-675-1936
- Phone: 770-838-8787
- Fax: 770-838-8922
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SUSAN
FOX
Title or Position: VP OPERATIONS
Credential:
Phone: 770-838-8845