person
Russell J Tanner, PA-C
Medical Physician Assistant in Bridgeport, Texas
NPI 1871544486

Russell J Tanner is a Medical Physician Assistant based in Bridgeport, TX and is specialized in Medical. Russell J Tanner practices in Bridgeport, TX and has the professional credentials of PA-C. The NPI Number for Russell J Tanner is 1871544486 and holds a License No. PA02552 (Texas).

The current practice location address for Russell J Tanner is 808 Woodrow Wilson Ray Cir, Bridgeport, TX and can be reached out via phone at 940-683-2297 and via fax at 940-683-2984.

Location: 808 Woodrow Wilson Ray Cir, Bridgeport, TX, 76426-2061
person
Provider Profile Details
NPI Number
1871544486
Provider Name
Russell J Tanner
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
808 Woodrow Wilson Ray Cir, Bridgeport, TX, 76426-2061
Phone Number
940-683-2297
Fax Number
940-683-2984
Provider Enumeration Date
05/16/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
808 Woodrow Wilson Ray Cir
City
State
Zip
76426-2061
Phone Number
940-683-2297
Fax Number
940-683-2984
person
Provider Business Mailing Address Details
Address
808 Woodrow Wilson Ray Cir
City
State
Zip
76426-2061
Phone Number
940-683-2297
Fax Number
940-683-2984
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA02552 (Texas)
Definition
Definition to come...
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