Provider Demographics
NPI:1811005796
Name:TANNA, CAROLA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLA
Middle Name:ANN
Last Name:TANNA
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 1:650 N LEE HWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450
Mailing Address - Country:US
Mailing Address - Phone:540-463-0951
Mailing Address - Fax:540-463-0954
Practice Address - Street 1:650 N LEE HWY
Practice Address - Street 2:SUITE 2
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450
Practice Address - Country:US
Practice Address - Phone:540-463-0951
Practice Address - Fax:540-463-0954
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036--106460207R00000X
VA0101056626207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH72496Medicare UPIN