Healthcare Provider Details

I. General information

NPI: 1669051439
Provider Name (Legal Business Name): TYLER SHEAHAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5131 BEACON HILL RD STE 110E
COLUMBUS OH
43228-4442
US

IV. Provider business mailing address

PO BOX 7527
DUBLIN OH
43017-0727
US

V. Phone/Fax

Practice location:
  • Phone: 614-544-1880
  • Fax:
Mailing address:
  • Phone: 614-788-6010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number34.016703
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: