NPI 1558513184

Mike Y. Tan, M.D.P.C.

Organisation Case Management Agency Jonesboro, GA

Practice location

Address: 6911 Tara Blvd Suite 111, Jonesboro, GA 30236-1503
Phone: (770) 478-2057
Mailing address: 3094 Bay View Dr, Jonesboro, GA 30236-4142

Authorised official

Name: Mike Yap Tan
Title: President/Ceo
Phone: (770) 478-2057

Registered specialties

Case Management Agency Primary

Agencies Taxonomy 251B00000X Licence 017494 (GA)

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Registry record

NPI: 1558513184
Entity type: Organization
NPI issued: 14 Oct 2008
Record last updated: 14 Oct 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.