Healthcare Provider Details

I. General information

NPI: 1235347154
Provider Name (Legal Business Name): TYLER ARKLESS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 04/10/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S 6TH ST
WILLIAMS AZ
86046-0110
US

IV. Provider business mailing address

788 ROUTE 4 APT 902
SINAJANA GU
96910-3356
US

V. Phone/Fax

Practice location:
  • Phone: 928-635-4441
  • Fax:
Mailing address:
  • Phone: 671-688-0258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number46609
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: