Tanner, John Calvin

Tanner, John Calvin is an individual health care provider with primary practice located at 340 16Th Ave N Ste A , Jacksonville Beach FL 32250-4819. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Tanner, John Calvin can be contacted via phone (904) 241-2653.

Contact Information

Primary practice address
340 16Th Ave N Ste A Jacksonville Beach FL 32250-4819
Phone: (904) 241-2653
Fax: (904) 758-0559
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS0004709 Florida
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X OS0004709 Florida
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X OS4709 Florida

Profile Details

NPI number 1952337990
LBN Legal business name Tanner, John Calvin
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Sep 21st, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952337990 NPPES
Florida MEDICAID 010659200
Florida Other 82622
Florida MEDICAID 068895900
Florida Other 080025596

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