Provider Demographics
NPI:1578514915
Name:TARNOSKY, ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:TARNOSKY
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 1:12831 6TH ST STE E
Mailing Address - Street 2:
Mailing Address - City:LILLIAN
Mailing Address - State:AL
Mailing Address - Zip Code:36549-4166
Mailing Address - Country:US
Mailing Address - Phone:251-962-4111
Mailing Address - Fax:251-962-4112
Practice Address - Street 1:12831 6TH ST STE E
Practice Address - Street 2:
Practice Address - City:LILLIAN
Practice Address - State:AL
Practice Address - Zip Code:36549-4166
Practice Address - Country:US
Practice Address - Phone:251-962-4111
Practice Address - Fax:251-962-4112
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0089741207Q00000X
ALMD.42429207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269410700Medicaid
FL269410700Medicaid