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General NPI Number Information
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NPI Number | 1508961319
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Entity Type | Individual
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Provider Name | CARL TAHN M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 107 LONGWOOD AVE
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City | ROCKLEDGE
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State | FL
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Zip | 32955
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Country | US
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Telephone | 321-636-2111
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Fax | 321-636-7180
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Provider Business Mailing Address
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Address Line | 908 W 4TH NORTH ST
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City | MORRISTOWN
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State | TN
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Zip | 37814-3894
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Country | US
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Telephone | 423-492-6100
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Fax | 423-492-6101
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | M-2288
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License Number State | GU
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 2018033152
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 89137
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 0101281530
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 2018033152
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License Number State | MO
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Taxonomy #6
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 0447691
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License Number State | KS
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