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General NPI Number Information
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NPI Number | 1932600145
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Entity Type | Individual
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Provider Name | TYLER ERNEST PATRICK DO
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Gender | Male
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Dates
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Enumeration Date | 02/22/2018
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Last Update Date | 06/25/2023
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Provider Practice Location Address
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Address Line | 50 UNION STREET
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City | ELLSWORTH
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State | ME
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Zip | 04605-2119
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Country | US
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Telephone | 72-664-5658
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Fax |
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Provider Business Mailing Address
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Address Line | 1170 SHORE ROAD
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City | LAMOINE
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State | ME
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Zip | 04605
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Country | US
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Telephone | 603-978-6076
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | DO3615
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License Number State | ME
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