Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 23880 | MS |
Y | 207K00000X | Allergist & Immunologist | 26872 | TN |
N | 207KA0200X | Allergist | 26872 | TN |
N | 207N00000X | Dermatologist | 26872 | TN |
N | 207NP0225X | Pediatric Dermatologist | 26872 | TN |
N | 207RA0201X | Internist - Allergy & Immunology | 26872 | TN |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 26872 | TN |
N | 2080P0201X | Pediatric Allergist | 26872 | TN |
NPI | 1114997814 |
---|---|
Provider Name | Dr. Michael S. Tankersley |
First Address | Collierville, TN 38017-0631 |
Second Address | Collierville, TN 38017-0631 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 17/11/2021 |