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NPI Code Detail

MEDICARE: DR. TYLER J GLENN M.D.

MEDICARE: DR. TYLER J GLENN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RP1001XPulmonary Disease Physician33292AZ
2207RC0200XCritical Care Medicine (Internal Medicine) Physician33292AZ
3207R00000XInternal Medicine Physician33292AZ

General Provider Information

NPI Number : 1013991173
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TYLER J GLENN M.D.
Provider Business Mailing Address
First Line : 7301 E 2ND ST STE 315
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-5627
Country : US
Telephone Number : 480-994-9838
Fax Number : 480-994-5811
Provider Business Practice Location Address
First Line : 7400 E OSBORN RD
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-6432
Country : US
Telephone Number : 480-994-9838
Fax Number : 480-994-5811
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 04/29/2024

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Directions to “ DR. TYLER J GLENN M.D.” Practice Location

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