Provider Demographics
NPI:1679732788
Name:TANNER, ERIKA LOVE (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:LOVE
Last Name:TANNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:115 FOUNTAINS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-6344
Mailing Address - Country:US
Mailing Address - Phone:601-853-0100
Mailing Address - Fax:601-853-3999
Practice Address - Street 1:115 FOUNTAINS BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-6344
Practice Address - Country:US
Practice Address - Phone:601-853-0100
Practice Address - Fax:601-853-3999
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS21057207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology