National Provider Identifier
Douglas Evan Tanner, PHYSICIAN ASSISTANT
Douglas Evan Tanner, PHYSICIAN ASSISTANT is listed in the NPPES registry with a primary specialty of Physician Assistant in Springville, NY and a listed phone number of (716) 592-3635.
Profile Overview
- NPI
- 1386688307
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- June 16, 2006
- Last Updated
- April 14, 2008
Practice Location
- 210 E Main St
- Springville, NY 14141-1442
Phone: (716) 592-3635
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1386688307
- Entity Type
- Individual
- Last Name
- Tanner
- First Name
- Douglas
- Middle Name
- Evan
- Name Prefix
- Mr.
- Credential
- PHYSICIAN ASSISTANT
- Mailing Street Address
- 210 E Main St
- Mailing City
- Springville
- Mailing State
- NY
- Mailing ZIP Code
- 14141-1442
- Mailing Country
- US
- Mailing Phone
- (716) 592-3635
- Practice Street Address
- 210 E Main St
- Practice City
- Springville
- Practice State
- NY
- Practice ZIP Code
- 14141-1442
- Practice Country
- US
- Practice Phone
- (716) 592-3635
- Enumeration Date
- June 16, 2006
- Last Updated
- April 14, 2008
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)
- Other Identifiers
- 9514284AOA (NY, Independent Health), 0003153 (NY, Ghi), 00026501103 (NY, Univera), 000570091007 (NY, BCBS), 01666426 (NY), P00459731 (NY, Rrmedicare)