Tanner, Johnson Dean

Tanner, Johnson Dean is an individual health care provider with primary practice located at 113 W Jackson St Ste B , Ridgeland MS 39157-2402. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Tanner, Johnson Dean can be contacted via phone (601) 354-4327.

Contact Information

Primary practice address
113 W Jackson St Ste B Ridgeland MS 39157-2402
Phone: (601) 354-4327
Fax: (601) 360-0822
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 15195 Mississippi
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 15195 Mississippi

Profile Details

NPI number 1336237825
LBN Legal business name Tanner, Johnson Dean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2006
Last updated Oct 22nd, 2021 - about 4 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 1336237825 NPPES
Mississippi MEDICAID 0124325

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