| Doctor Name: | JAMES WES TANNER |
| NPI Number: | 1568451318 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 018256 |
| Business Practice Address: | 1722 State Road 44 New Smyrna Beach, FL - 321688339 |
| Business Phone Number: | 3864283241 |
| Business Fax Number: | 3864278440 |
| Mailing Address: | 1722 State Road 44, NEW SMYRNA BEACH |
| State: | FL |
| Postal Code: | 321688339 |
| Phone Number: | 3864283241 |
| Fax Number: | 3864278440 |
| NPI Enumeration Date: | 10/14/2005 |
| NPI Last Update Date: | 12/18/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 018256 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |