Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tanner Wallen, DO

Individual provider Pulmonary Disease Physician · NPI 1043731870

Tanner Wallen, DO is a Pulmonary Disease in Saint Louis, Missouri. Graduated from At Still University of Health Sciences, College of Osteo Med, Kirksville in 2017, 9 years ago. Practices with SSM Medical Group Inc, a 560-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
9
Trained at
At Still University of Health Sciences, College of Osteo Med, Kirksville
Licensed in
MO
In the registry since
2017
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

12255 Depaul Dr Ste 500
Saint Louis, MO 63044
Phone: (314) 209-5180
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pulmonary Disease Physician (primary) Taxonomy 207RP1001X · Licence 2020024367 (MO)
Internal Medicine Physician Taxonomy 207R00000X · Licence 2020024367 (MO)

Record details

NPI number1043731870
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 1, 2017
Last updated in NPPESJuly 1, 2026
Certification dateJuly 1, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPULMONARY DISEASE
Medical schoolAT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated 2017 (9 years in practice)
Group practice Ssm Medical Group Inc — 560 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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