Provider Demographics
NPI:1215970785
Name:TANNER, JAMES ARDEN (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ARDEN
Last Name:TANNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9500 KANIS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6324
Mailing Address - Country:US
Mailing Address - Phone:501-224-6699
Mailing Address - Fax:501-224-6481
Practice Address - Street 1:12921 CANTRELL RD
Practice Address - Street 2:SUITE 300
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-1701
Practice Address - Country:US
Practice Address - Phone:501-907-6699
Practice Address - Fax:501-224-6481
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2008-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARC-5307207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR160006522OtherRAILROAD MEDICARE
AR55208OtherBCBS
AR4203408OtherAETNA
AR7282OtherUNITED HEALTHCARE
AR114830000-01OtherQUALCHOICE
AR104935001Medicaid
AR710619986OtherCIGNA
AR710619986OtherCIGNA
AR7282OtherUNITED HEALTHCARE