Provider Demographics
NPI:1871784645
Name:TANNER FAMILY HEALTHCARE OF FRANKLIN INC
Entity type:Organization
Organization Name:TANNER FAMILY HEALTHCARE OF FRANKLIN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-838-8845
Mailing Address - Street 1:PO BOX 896096
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28289-6096
Mailing Address - Country:US
Mailing Address - Phone:770-838-8787
Mailing Address - Fax:770-838-8922
Practice Address - Street 1:2906 FRANKLIN PKWY
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:GA
Practice Address - Zip Code:30217-7544
Practice Address - Country:US
Practice Address - Phone:706-675-6949
Practice Address - Fax:706-675-1936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GADG3400OtherMEDICARE ID
GAGRP8137Medicare PIN
GADG3400OtherMEDICARE ID