Tanner, Lydia Chaney

Tanner, Lydia Chaney is an individual health care provider with primary practice located at 100 Doctors Dr Ste G , Douglas GA 31533-2211. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Tanner, Lydia Chaney can be contacted via phone (912) 384-6186.

Contact Information

Primary practice address
100 Doctors Dr Ste G Douglas GA 31533-2211
Fax: (912) 384-6187
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 53885 Georgia

Profile Details

NPI number 1790799740
LBN Legal business name Tanner, Lydia Chaney
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
Last updated Jul 21st, 2022 - about 3 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 1790799740 NPPES
Georgia MEDICAID 366115747B
Georgia Other 053885
Georgia MEDICAID 366115747A

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