Provider Demographics
NPI:1124229679
Name:TENNANT, JOSHUA (MD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:TENNANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3144 BIOINFORMATICS BLDG
Mailing Address - Street 2:130 MASON FARM RD
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7055
Mailing Address - Country:US
Mailing Address - Phone:919-966-9066
Mailing Address - Fax:919-966-6730
Practice Address - Street 1:3144 BIOINFORMATICS BLDG
Practice Address - Street 2:130 MASON FARM RD
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7055
Practice Address - Country:US
Practice Address - Phone:919-966-9066
Practice Address - Fax:919-966-6730
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-02043207XX0004X
NC140852390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program