MEDICARE: DR. JOHN CALVIN TANNER DO

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	207Q00000X	Family Medicine Physician	OS0004709	FL
2	207QA0401X	Addiction Medicine (Family Medicine) Physician	OS0004709	FL
3	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician	OS4709	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	080025596	OTHER	FL	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	82622	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1952337990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN CALVIN TANNER DO

Provider Business Mailing Address
First Line	:	PO BOX 51595
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32240-1595
Country	:	US
Telephone Number	:	904-571-9439
Fax Number	:	904-758-0559

Provider Business Practice Location Address
First Line	:	340 16TH AVE N STE A
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-4819
Country	:	US
Telephone Number	:	904-241-2653
Fax Number	:	904-758-0559

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	05/16/2025

Similar Medicare Providers

1104867670 — JANET S MOULTON INC
Practice Location Address:

340 16TH AVE N , STE B
JACKSONVILLE BEACH, FL
32250-4819

Practice Phone: 904-249-8893
Practice Fax: 904-372-0496

1467495242 — MILLICENT TANNER R.D.,C.D.E.
Practice Location Address:

340 16TH AVE N
JACKSONVILLE BEACH, FL
32250-4819

Practice Phone: 904-247-1911
Practice Fax: 904-247-9736

1114029782 — MRS. MEGHAN ANDERSON A.R.N.P.
Practice Location Address:

340 16TH AVE N
JACKSONVILLE BEACH, FL
32250-4819

Practice Phone: 904-247-1911
Practice Fax: 904-247-9736

1851419246 — MS. ANGELA MAHONEY KREIDL MS OTRL
Practice Location Address:

340 16TH AVE N STE B
JACKSONVILLE BEACH, FL
32250-4819

Practice Phone: 904-249-8893
Practice Fax: 904-879-5707

1477964732 — MISS JOHANNA MARIE JUDD MS, OTR/L, CLT
Practice Location Address:

340 16TH AVE N STE B
JACKSONVILLE BEACH, FL
32250-4819

Practice Phone: 440-413-6379
Practice Fax:

1669926002 — UNITED RECOVERY CENTERS LLC
Practice Location Address:

340 16TH AVE N
JACKSONVILLE BEACH, FL
32250-4819

Practice Phone: 305-467-8666
Practice Fax:

Directions to “ DR. JOHN CALVIN TANNER DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.