Tanner Medical Group Inc

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

TANNER MEDICAL GROUP INC

Doing business as

West Georgia Urology Associates

Practice address

150 Clinic Ave Ste 202
Carrollton, GA 30117-4402

Phone

(770) 834-6988

Fax

(770) 834-1090

NPI assigned

May 3, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Clint Hoffman

Title

Senior VP TMG Operations

Phone

(770) 838-8302

Specialties & licenses 1

Addresses

Other names 1

• West Georgia Urology Associates Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1043909302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GREENWAY BLVD FL 2",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174338",
            "telephone_number": "770-838-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CLINIC AVE STE 202",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174402",
            "telephone_number": "770-834-6988",
            "fax_number": "770-834-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANNER MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-03",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "CLINT",
        "authorized_official_title_or_position": "SENIOR VP TMG OPERATIONS",
        "authorized_official_telephone_number": "770-838-8302"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Georgia Urology Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Georgia Urology Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Non-Pharmacy Dispensing Site in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Non-Pharmacy Dispensing Site in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.