Healthcare Provider Details

I. General information

NPI: 1154064806
Provider Name (Legal Business Name): TYLER BROWN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 E EVANS AVE
DENVER CO
80210-4544
US

IV. Provider business mailing address

2480 ARAPAHOE ST UNIT 255
DENVER CO
80205-5794
US

V. Phone/Fax

Practice location:
  • Phone: 720-449-8050
  • Fax:
Mailing address:
  • Phone: 224-622-1266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-53527
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0075832
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: