MEDICARE: ARNOLD R TAG MD

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	2083P0011X	Undersea and Hyperbaric Medicine (Preventive Medicine) Physician	MD09336	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	136868	OTHER	TN	B/H
2	4165	OTHER	TN	TLC
3	040011136	OTHER		RR MED
4	4046854	OTHER	TN	B/C

General Provider Information

NPI Number	:	1821190109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARNOLD R TAG MD

Provider Business Mailing Address
First Line	:	384 MCELROY RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120-1535
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3950 NEW COVINGTON PIKE
Second Line	:	SUITE 350
City	:	MEMPHIS
State	:	TN
Zip	:	38128-2591
Country	:	US
Telephone Number	:	901-682-6828
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2006
Last Update Date	:	06/12/2009

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Directions to “ ARNOLD R TAG MD” Practice Location

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