Provider Demographics
NPI:1922422278
Name:TANNER, FRANK (SA-C, CSFA)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:TANNER
Suffix:
Gender:M
Credentials:SA-C, CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3142 HIGHWAY 278 NW # 135
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-2304
Mailing Address - Country:US
Mailing Address - Phone:678-516-2119
Mailing Address - Fax:
Practice Address - Street 1:3142 HIGHWAY 278 NW #135
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014
Practice Address - Country:US
Practice Address - Phone:678-516-2119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-06
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist