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General NPI Number Information
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NPI Number | 1427145614
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Entity Type | Organization
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Legal Business Name | ROBYN E TYLER MD
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Dates
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Enumeration Date | 10/07/2006
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Last Update Date | 09/13/2007
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Provider Practice Location Address
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Address Line | 7777 HENNESSY BLVD STE 102
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City | BATON ROUGE
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State | LA
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Zip | 70808-4300
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Country | US
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Telephone | 225-214-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 7777 HENNESSY BLVD STE 102
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City | BATON ROUGE
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State | LA
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Zip | 70808-4300
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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 | BUSINESS MANAGER
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Name | CHERYL TYLER
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Credential |
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Telephone | 225-214-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 013735
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License Number State | LA
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