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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

RUSSELL J TANNER, P.A.-C

Active

RUSSELL J TANNER, P.A.-C is a Medical Physician Assistant healthcare provider located in BRIDGEPORT, Texas. NPI 1871544486 is currently active in the NPPES registry. Verify at CMS.

Medical Physician Assistant · BRIDGEPORT, TX

Registration Details

NPI Number
1871544486
Provider Type
Individual
Gender
Male
NPI Issued
May 16, 2006 (20.237216852206 yrs)
Last Updated
Jul 8, 2007
License
PA02552 (TX)

Practice Information

Address
808 WOODROW WILSON RAY CIR
BRIDGEPORT, TX, 764262061
Browse TX providers · Browse ZIP 76426
Phone
9406832297
Fax
9406832984
Primary Specialty
Medical Physician Assistant
363AM0700X

Other Medical Physician Assistant Providers in BRIDGEPORT, TX

Name Credential NPI
MICHAEL A MILLIS P.A.-C 1659324739
KEVIN LEE DAVIS PA-C 1750739405
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.