Healthcare Provider Details

I. General information

NPI: 1821447020
Provider Name (Legal Business Name): TYLER JAMES SPIERING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2016
Last Update Date: 03/29/2024
Certification Date: 03/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 N 120TH AVE
HOLLAND MI
49424-2120
US

IV. Provider business mailing address

370 N 120TH AVE
HOLLAND MI
49424-2120
US

V. Phone/Fax

Practice location:
  • Phone: 616-396-5855
  • Fax: 877-592-0688
Mailing address:
  • Phone: 616-396-5855
  • Fax: 877-592-0688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number0116035012
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301109711
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number4301117263
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: