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Tanner C Carlock, MD
Student in an Organized Health Care Education/Training Program in Dayton, Ohio
NPI 1063049799

Tanner C Carlock is a Student in an Organized Health Care Education/Training Program based in Dayton, OH. Tanner C Carlock practices in Dayton, OH and has the professional credentials of MD. The NPI Number for Tanner C Carlock is 1063049799 and holds a License No. 33899 (Ohio).

The current practice location address for Tanner C Carlock is 1 Wyoming St, Dayton, OH and can be reached out via phone at 937-208-2850.

Location: 1 Wyoming St, Dayton, OH, 45409-2722
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1063049799
Provider Name
Tanner C Carlock
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1 Wyoming St, Dayton, OH, 45409-2722
Phone Number
937-208-2850
Fax Number
Provider Enumeration Date
03/24/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1 Wyoming St
City
Dayton
State
Ohio
Zip
45409-2722
Phone Number
937-208-2850
Fax Number
person
Provider Business Mailing Address Details
Address
1 Wyoming St
City
Dayton
State
Ohio
Zip
45409-2722
Phone Number
937-208-2850
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
33899 (Nebraska)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
33899 (Nebraska)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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