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General NPI Number Information
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NPI Number | 1013351477
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Entity Type | Individual
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Provider Name | TANNER WILLIAM BOES MD
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Gender | Male
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Dates
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Enumeration Date | 04/29/2013
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 11700 STUDT AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63141-7480
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Country | US
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Telephone | 314-989-1181
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Fax | 314-989-1441
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Provider Business Mailing Address
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Address Line | 11700 STUDT AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63141-7480
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Country | US
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Telephone | 314-989-1181
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Fax | 314-989-1441
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2025049439
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35.127937
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number | 295278
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 295278
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number | 2025049439
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License Number State | MO
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