MR. TANNER BO CARLSON (NPI# 1669982740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669982740 |
| Entity Type | Individual |
| Full Name | MR. TANNER BO CARLSON |
| Credential | PA-C |
| Practice Address |
1100 E Monroe St Ste 101 Globe AZ 85501-1304 |
| Mailing Address |
Po Box 1641 Globe AZ 85502-1641 |
| Practice Telephone | 9284258200 |
| Practice Fax Number | 9284258406 |
| Mailing Telephone | 9284258200 |
| Mailing Fax Number | 9284258406 |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2017-10-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
6896 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1100 E MONROE ST STE 101 |
| City | GLOBE |
| State | AZ |
| Zip Code | 85501-1304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558802884 | Mary Beth Patterson | Pharmacist | 100 S Ragus Rd, Globe, AZ 85501 | 2017-03-20 |
| 1255873402 | Christopher Sessions | Physician Assistant | 5880 N Hospital Drive, Globe, AZ 85501 | 2016-11-04 |
| 1235681156 | Michelle Pettitt | Naturopath | 138 S. Broad Street, Globe, AZ 85501 | 2016-10-26 |
| 1790154664 | Ryan Bradley | Physician Assistant | 5880 N Hospital Dr, Globe, AZ 85501 | 2015-09-21 |
| 1417297052 | Horizon Health and Wellness, Inc. | Community/Behavioral Health | 2250 Hwy 60, Suite I, Globe, AZ 85501 | 2013-02-19 |
| 1528307964 | William G Sypult | Internal Medicine | 8036 South Cherokee Drive, Globe, AZ 85501 | 2013-02-05 |
| 1821345752 | Community Bridges, Inc | Clinical Medical Laboratory | 5734 East Hope Lane, Globe, AZ 85501 | 2012-08-09 |
| 1417218876 | Canyonlands Community Health Care | Clinic/Center | 5860 South Hospital Drive, Ste 102, Globe, AZ 85501 | 2012-06-01 |
| 1770841215 | Cv Ob Gyn Women's Healthcare | Obstetrics & Gynecology | 5882 S Hospital Drive, Suite 1, Globe, AZ 85501 | 2012-05-02 |
| 1235420993 | Jennifer Lyn Davis | Licensed Vocational Nurse | 1300 South Street, Globe, AZ 85501 | 2011-04-28 |
| Find all providers in zip 85501 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972053072 | Laura Marie Paulson | Physician Assistant | 1100 N Broad St, Suite B, Globe, AZ 85501-2757 | 2016-10-12 |
| 1770802191 | Cj Campbell LLC | Physician Assistant | 1100 N Broad St, Globe, AZ 85501-2757 | 2010-05-25 |
| 1225107667 | Sherida Carlson | Physician Assistant | 108 S Broad St, Globe, AZ 85501-2602 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928374 | Michael James Porter | Physician Assistant | 20003 N 77th Dr, Glendale, AZ 85308-8339 | 2020-09-30 |
| 1073121505 | Alexandra R Koolmees | Physician Assistant | 1141 E Village Circle Dr S, Phoenix, AZ 85022-4818 | 2020-07-21 |
| 1194343897 | Alyssa Kay Poland | Physician Assistant | 10006 W Los Gatos Dr, Peoria, AZ 85383-3343 | 2020-07-08 |
| 1568080620 | Manuel Gerardo Pompa | Physician Assistant | 3848 N 3rd Ave Unit 3071, Phoenix, AZ 85013-3472 | 2020-07-06 |
| 1932748233 | Hayley Klotz | Physician Assistant | 440 N Navajo Dr, Page, AZ 86040-0950 | 2020-01-03 |
| 1285273987 | Jaclyn Marie Schroeder | Physician Assistant | 7649 E Pinnacle Peak Rd Ste 100, Scottsdale, AZ 85255-6296 | 2019-12-27 |
| 1396388062 | Morgan Taylor Beckwith | Physician Assistant | 2128 Senita Dr, Lake Havasu City, AZ 86403-5756 | 2019-10-24 |
| 1023667623 | Halie Furrier | Physician Assistant | 5345 E Gleneagles Dr, Tucson, AZ 85718-1803 | 2019-09-05 |
| 1871155143 | Terry Craven Wood | Physician Assistant | 7645 W Donald Dr, Peoria, AZ 85383-3142 | 2019-07-08 |
| 1720548753 | Alexis D Elliott | Physician Assistant | 2350 Miracle Mile # 600a, Bullhead City, AZ 86442-7505 | 2019-03-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.