MICHAEL TANNER LIBSACK

FLAGSTAFF, AZ
NPI1659830974
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207L00000X Anesthesiology
(Licence: AZ  011715)
Enumeration Date2019-03-16
Last Update Date2025-06-24
Business Address
MICHAEL TANNER LIBSACK DO
1200 N BEAVER ST
FLAGSTAFF, AZ 86001-3118
Phone number: 928-779-3366
Mailing Address
MICHAEL TANNER LIBSACK DO
1200 N BEAVER ST ATTN: PAYER CREDENTIALING
FLAGSTAFF, AZ 86001-3118
Phone number: 928-213-6235
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