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Contact Information

JOHN C TANNER III, MD
3366 OAKDALE AVE N
SUITE 103
ROBBINSDALE, MN55422-2948
 Phone: 763-520-7870
 Fax: 763-520-7580
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Foot and Ankle Surgery

207XX0004X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for JOHN C TANNER III · (Male)

NPI # 1780882662
Status Active
Credentials MD
Entity Individual
Enumeration date 07/03/2007
Last updated 08/26/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301090393
  • MN License # 109070
Hospital affiliation(s)
  • MAPLE GROVE HOSPITAL - (Acute Care)
    9875 HOSPITAL DRIVE
    MAPLE GROVE, MN 55369
  • NORTH MEMORIAL MEDICAL CENTER - (Acute Care)
    3300 OAKDALE NORTH
    ROBBINSDALE, MN 55422
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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