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NPI Code Detail

MEDICARE: BRYANT A. TARR DPM

MEDICARE: BRYANT A. TARR DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213ES0000XSports Medicine Podiatrist1971MA
2213ES0131XFoot Surgery Podiatrist1971MA
3213E00000XPodiatrist1971MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013906171
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYANT A. TARR DPM
Provider Business Mailing Address
First Line : 111 BOSTON POST RD
Second Line : STE108
City : SUDBURY
State : MA
Zip : 01776-2463
Country : US
Telephone Number : 978-443-4878
Fax Number : 978-443-1470
Provider Business Practice Location Address
First Line : 111 BOSTON POST RD
Second Line : SUITE 108
City : SUDBURY
State : MA
Zip : 01776-2463
Country : US
Telephone Number : 978-443-4878
Fax Number : 978-443-1470
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 01/07/2008

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