DR. DUSTIN JAMES TANNER D.C. NPI 1790012201

NPI Information

NPI: 1790012201
Provider Name: DR. DUSTIN JAMES TANNER, D.C.
Classification: Chiropractor - 111N00000X
Entity Type: Individual
Address:
2200 N PONCE DE LEON BLVD
SUITE #1
ST AUGUSTINE, FL
ZIP 32084
Phone: (904) 819-9110
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DR. Dustin James Tanner, D.C. is a chiropractor in St Augustine, FL. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. DR. Dustin James Tanner, D.C. NPI is 1790012201. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2200 N PONCE DE LEON BLVD
SUITE #1
ST AUGUSTINE, FL
ZIP 32084-600
Phone: (904) 819-9110
Fax: (904) 819-9310

The enumeration date for this NPI number is 11/5/2009 and was last updated on 5/29/2012.

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
1	111N00000X	Chiropractor		X012022-1	NEW YORK	No
2	111N00000X	Chiropractor		CH 10578	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	J300052763D	MEDICARE UPIN	FLORIDA

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: 5/5/2024

NPI Synchronization or Removal

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