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NPI Code Detail

MEDICARE: ANTHONY TANNER PA(ASCP)CM

MEDICARE:   ANTHONY  TANNER  PA(ASCP)CM
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
1246Q00000XPathology Specialist/Technologist000512NY

General Provider Information

NPI Number : 1841020468
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY TANNER PA(ASCP)CM
Provider Business Mailing Address
First Line : 607 MATADOR CT
Second Line :
City : BOSSIER CITY
State : LA
Zip : 71111-8232
Country : US
Telephone Number : 601-467-4646
Fax Number :
Provider Business Practice Location Address
First Line : 607 MATADOR CT
Second Line :
City : BOSSIER CITY
State : LA
Zip : 71111-8232
Country : US
Telephone Number : 601-467-4646
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2024
Last Update Date : 08/07/2024

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Directions to “ ANTHONY TANNER PA(ASCP)CM” Practice Location

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