Healthcare Provider Details

I. General information

NPI: 1578947339
Provider Name (Legal Business Name): TYLER WATSON DA, MPH, MCHES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2015
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1356 NELSON CIR
ST GEORGE UT
84790-7644
US

IV. Provider business mailing address

PO BOX 194
ST GEORGE UT
84771-0194
US

V. Phone/Fax

Practice location:
  • Phone: 208-206-6430
  • Fax:
Mailing address:
  • Phone: 208-206-6430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: