Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1987
NPI: 1881656288
Practice Locations (1)
TANNER MEDICAL GROUP INC
150 CLINIC AVE, SUITE 202
CARROLLTON, GA 301174402
7708346988
Source: CMS National Downloadable File, September 2026.