Healthcare Provider Details

I. General information

NPI: 1073737672
Provider Name (Legal Business Name): JARET D TYLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/15/2020
Certification Date: 07/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3705 OLENTANGY RIVER RD STE 100
COLUMBUS OH
43214-3467
US

IV. Provider business mailing address

5450 FRANTZ RD STE 360
DUBLIN OH
43016-4141
US

V. Phone/Fax

Practice location:
  • Phone: 614-262-6772
  • Fax: 614-533-0162
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35.087931
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number35.087931
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: