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General NPI Number Information
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NPI Number | 1558298810
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Entity Type | Individual
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Provider Name | BRIAN TANNEHILL
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Gender | Male
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Dates
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Enumeration Date | 05/08/2026
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Last Update Date | 05/08/2026
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Provider Practice Location Address
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Address Line | 140 FIRST AVENUE
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City | ECLECTIC
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State | AL
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Zip | 36024
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Country | US
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Telephone | 334-541-4425
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Fax |
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Provider Business Mailing Address
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Address Line | 52 MEADOWVIEW DR
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City | WETUMPKA
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State | AL
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Zip | 36092-4258
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Country | US
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Telephone |
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Fax |
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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 | 146M00000X
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Taxonomy Name | Intermediate Emergency Medical Technician
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License Number | 2400076
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License Number State | AL
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