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General NPI Number Information
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NPI Number | 1295354769
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Entity Type | Individual
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Provider Name | ALEXANDER TYSON MD
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Gender | Male
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Dates
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Enumeration Date | 04/14/2020
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 3100 MAIN ST STE 705
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City | MAUMEE
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State | OH
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Zip | 43537-9867
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Country | US
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Telephone | 419-383-2777
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Fax | 419-383-2731
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Provider Business Mailing Address
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Address Line | 3000 ARLINGTON AVE STOP 1108
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City | TOLEDO
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State | OH
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Zip | 43614-2595
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35.149094
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License Number State | OH
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