MEDICARE: TARRANT MEDICAL, P. C.

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
1	261QP2300X	Primary Care Clinic/Center
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1568138980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TARRANT MEDICAL, P. C.

Provider Business Mailing Address
First Line	:	2038 SPRINGDALE LN
Second Line	:
City	:	TARRANT
State	:	AL
Zip	:	35217-2028
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2038 SPRINGDALE LN
Second Line	:
City	:	TARRANT
State	:	AL
Zip	:	35217-2028
Country	:	US
Telephone Number	:	205-841-7665
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	DR. SIDDHARTH SHAH
Credential	:
Telephone Number	:	205-841-7665

Provider Enumeration Date	:	08/17/2021
Last Update Date	:	12/13/2023

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