Tanner, Ronald Douglas

Tanner, Ronald Douglas is an individual health care provider with primary practice located at 4421 Oak Park Ln Ste 102 , Fort Worth TX 76109-9541. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Tanner, Ronald Douglas can be contacted via phone (817) 732-2878.

Contact Information

Primary practice address
4421 Oak Park Ln Ste 102 Fort Worth TX 76109-9541
Phone: (817) 732-2878
Fax: (817) 732-9315
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X K8515 Texas
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X K8515 Texas

Profile Details

NPI number 1568441616
LBN Legal business name Tanner, Ronald Douglas
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2006
Last updated Jun 19th, 2009 - about 17 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 1568441616 NPPES
Texas MEDICAID 040573013
Texas MEDICAID 040573014
Texas MEDICAID 040573016
Texas Other P00005154
Texas Other 8A3354
Texas MEDICAID 040573015

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