TANNER MEDICAL GROUP INC NPI 1043909302

NPI Information

  • NPI: 1043909302
  • Provider Name: TANNER MEDICAL GROUP INC
  • Classification: Non-Pharmacy Dispensing Site - 332900000X
  • Entity Type: Organization
  • Doing Business As: WEST GEORGIA UROLOGY ASSOCIATES
  • CLIA Number: 11D1066229
  • Address: 150 CLINIC AVE STE 202
    CARROLLTON, GA
    ZIP 30117
  • Phone: (770) 834-6988

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NPI Details

TANNER MEDICAL GROUP INC is a non pharmacy dispensing site in Carrollton, GA. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) TANNER MEDICAL GROUP INC NPI is 1043909302. The provider is registered as an organization entity type.
The provider Is Doing Business As West Georgia Urology Associates.

The provider's business location address is:

150 CLINIC AVE STE 202
CARROLLTON, GA
ZIP 30117-402
Phone: (770) 834-6988
Fax: (770) 834-1090

The provider's authorized official is Clint Hoffman .
The authorized official title is Senior Vp Tmg Operations and has the following contact phone number (770) 838-8302.

The CLIA number assigned to this NPI record is 11D1066229 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/3/2023 and was last updated on 2/29/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332900000XNon-Pharmacy Dispensing SiteYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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