Provider Demographics
NPI:1275576332
Name:TANNER, CATHERINE COBURN (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:COBURN
Last Name:TANNER
Suffix:
Gender:F
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:DOGWOOD AVE
Mailing Address - Street 2:BLG 160
Mailing Address - City:MTN HOME
Mailing Address - State:TN
Mailing Address - Zip Code:37684
Mailing Address - Country:US
Mailing Address - Phone:423-926-1121
Mailing Address - Fax:423-079-3528
Practice Address - Street 1:BLG 160 DOGWOOD AVE
Practice Address - Street 2:
Practice Address - City:MTN HOME
Practice Address - State:TN
Practice Address - Zip Code:37684
Practice Address - Country:US
Practice Address - Phone:423-926-1121
Practice Address - Fax:423-079-3528
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD24621207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine